We aimed to determine the relationship between handgrip strength, smoking, and alcohol consumption in young men and fracture risk at middle age. Thus, we carried out a cohort study including young men undergoing conscription examination in Sweden from September 1969 to May 1970 at a typical age of 18 years. Data on muscle strength, height, weight, and lifestyle factors were linked to the National Patient Register 1987-2010. Handgrip strength was considered the main exposure and smoking and alcohol consumption as secondary exposures. Outcomes were all fractures (except face, skull, digits), major osteoporotic fractures (thoracic/lumbar spine, proximal humerus, distal forearm or hip), and major traumatic fractures (shaft of humerus, forearm, femur, or lower leg) based on ICD-9 and -10 codes. We used Cox regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) according to handgrip strength as a continuous variable (per 1 SD), after adjustment for weight, height, parental education, smoking, and alcohol consumption. A total of 40,112 men were included, contributing 892,572 person-years. Overall, 3974 men fractured in middle age with the incidence rate (95% CI) of 44.5 (43.2-45.9) per 1000 person-years. The corresponding rates were12.2 and 5.6 per 1000 person-years for major osteoporotic and traumatic fractures, respectively. Handgrip strength-adjusted HR (95% CI) was 1.01 (0.98-1.05), 0.94 (0.88-1.00), and 0.98 (0.88-1.08) per SD for all, major osteoporotic, and major traumatic fractures, respectively. Adjusted HR (95% CI) for smokers (>21 cigarettes/d) was 1.44 (1.21, 1.71) for all fractures, while the association between alcohol consumption and hazards of fracture was J-shaped. Therefore, young adult handgrip strength was not associated with fracture risk in middle-age men, although smoking and high alcohol consumption did confer an increased risk. © 2019 American Society for Bone and Mineral Research. © 2019 American Society for Bone and Mineral Research.

中文翻译：

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吸烟和酗酒，但年轻人的肌肉力量却没有增加中年发生骨折的风险：一项与瑞典国家患者注册系统相关的队列研究。

我们旨在确定年轻男性的握力，吸烟和饮酒与中年骨折风险之间的关系。因此，我们进行了一项队列研究，其中包括从1969年9月至1970年5月在瑞典接受典型应征年龄的18岁的年轻人。肌肉力量，身高，体重和生活方式因素的数据与1987-2010年国家患者登记簿相关。握力被认为是主要暴露，吸烟和饮酒是次要暴露。结果是基于以下原因的所有骨折（面部，颅骨，趾骨除外），主要骨质疏松性骨折（胸/腰椎，肱骨近端，前臂或髋骨远端）以及主要外伤性骨折（肱骨干，前臂，股骨或小腿）。 ICD-9和-10代码。我们在调整体重，身高，父母教育，吸烟和饮酒量后，根据握力作为连续变量（每1 SD），使用Cox回归模型估算危险比（HR）和95％置信区间（CI）。总共包括40,112名男性，贡献892,572人年。总体而言，有3974例中年人骨折，每1000人年的发生率（95％CI）为44.5（43.2-45.9）。严重骨质疏松和创伤性骨折的相应发生率分别为每千人年12.2和5.6。对于所有骨质疏松性骨折和重大外伤性骨折，每个SD的握力调整后的HR（95％CI）分别为1.01（0.98-1.05），0.94（0.88-1.00）和0.98（0.88-1.08）。对于所有骨折，吸烟者（> 21支香烟/ d）的调整后HR（95％CI）为1.44（1.21，1.71），饮酒与骨折危险之间的关系呈J型。因此，尽管吸烟和大量饮酒确实增加了患病风险，但年轻的成人握力强度与中年男性的骨折风险无关。©2019美国骨骼和矿物质研究学会。©2019美国骨骼和矿物质研究学会。