Hyperkyphotic posture and risk of future osteoporotic fractures: The Rancho Bernardo study

被引:130
作者
Huang, MH
Barrett-Connor, E
Greendale, GA
Kado, DM
机构
[1] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Geriatr, Los Angeles, CA 90095 USA
[2] Univ Calif San Diego, Sch Med, Dept Family Med & Prevent Med, La Jolla, CA 92093 USA
关键词
kyphosis; hyperkyphosis; aging; osteoporosis; fractures;
D O I
10.1359/JBMR.051201
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
It is unknown whether kyphosis of the thoracic spine is an independent risk factor for future osteoporotic fractures. In 596 community-dwelling women, we found that with increasing kyphosis, there was a significant trend of increasing fracture risk that was independent of previous history of fractures or BMD. Introduction: It IS unknown whether kyphosis of the thoracic spine is an independent risk factor for future osteoporotic fractures. Materials and Methods: We conducted a prospective cohort study of 596 community-dwelling women, 47-92 years of age. Between 1988 and 1991, BMD of the hip and spine and kyphosis were measured. Kyphosis was measured by counting the number of 1.7-cm blocks necessary to place under the occiput so participants could lie flat without neck hyperextension. New fractures were reported over an average follow-up of 4 years. Results: Using a cut-off of at least one block, 18% of the participants had hyperkyphotic posture (range, one to nine blocks). There were 107 women who reported at least one new fracture (hip, spine, wrist, clavicle, shoulder, arm, hand, rib, pelvis, leg, or ankle). In logistic regression analyses, older women with hyperkyphotic posture (defined as at least one block) had a 1.7-fold increased risk of having a future fracture independent of age, prior fracture, and spine or hip BNID (95% Cl: 1.00-2.97; p = 0.049). There was a significant trend of increasing fracture risk with increasing number of blocks, with ORs ranging from 1.5 to 2.6 as the number of blocks increased from one to at least three blocks compared with those with zero blocks (trend p = 0.03; models adjusted for age, baseline fracture, spine or hip BMD). Stratification by baseline fracture status and controlling for other possible confounders or past year falls did not change the results. Conclusions: Whereas hyperkyphosis may often result front vertebral fractures, Our study findings suggest that hyperkyphotic posture itself may be an important risk factor for future fractures, independent of low BMD or fracture history.
引用
收藏
页码:419 / 423
页数:5
相关论文
共 19 条
[1]   Prevalent vertebral deformities predict hip fractures and new vertebral deformities but not wrist fractures [J].
Black, DM ;
Arden, NK ;
Palermo, L ;
Pearson, J ;
Cummings, SR .
JOURNAL OF BONE AND MINERAL RESEARCH, 1999, 14 (05) :821-828
[2]  
CHOW RK, 1987, AM J PHYS MED REHAB, V66, P219
[3]   Thoracic kyphosis and ventilatory dysfunction in unselected older persons: An epidemiological study in Dicomano, Italy [J].
Di Bari, M ;
Chiarlone, M ;
Matteuzzi, D ;
Zacchei, S ;
Pozzi, C ;
Bellia, V ;
Tarantini, F ;
Pini, R ;
Masotti, G ;
Marchionni, N .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2004, 52 (06) :909-915
[4]   KYPHOSIS IN OLDER WOMEN AND ITS RELATION TO BACK PAIN, DISABILITY AND OSTEOPENIA - THE STUDY OF OSTEOPOROTIC FRACTURES [J].
ETTINGER, B ;
BLACK, DM ;
PALERMO, L ;
NEVITT, MC ;
MELNIKOFF, S ;
CUMMINGS, SR .
OSTEOPOROSIS INTERNATIONAL, 1994, 4 (01) :55-60
[5]   VERTEBRAL FRACTURE ASSESSMENT USING A SEMIQUANTITATIVE TECHNIQUE [J].
GENANT, HK ;
WU, CY ;
VANKUIJK, C ;
NEVITT, MC .
JOURNAL OF BONE AND MINERAL RESEARCH, 1993, 8 (09) :1137-1148
[6]   Hyperkyphotic posture and poor physical functional ability in older community-dwelling men and women: The Rancho Bernardo study [J].
Kado, DM ;
Huang, MH ;
Barrett-Connor, E ;
Greendale, GA .
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, 2005, 60 (05) :633-637
[7]  
Kado DM, 2003, J BONE MINER RES, V18, pS249
[8]   Hyperkyphotic posture predicts mortality in older community-dwelling men and women: A prospective study [J].
Kado, DM ;
Huang, MH ;
Karlamangla, AS ;
Barrett-Connor, E ;
Greendale, GA .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2004, 52 (10) :1662-1667
[9]   Vertebral fractures and mortality in older women -: A prospective study [J].
Kado, DM ;
Browner, WS ;
Palermo, L ;
Nevitt, MC ;
Genant, HK ;
Cummings, SR .
ARCHIVES OF INTERNAL MEDICINE, 1999, 159 (11) :1215-1220
[10]   Patients with prior fractures have an increased risk of future fractures: A summary of the literature and statistical synthesis [J].
Klotzbuecher, CM ;
Ross, PD ;
Landsman, PB ;
Abbott, TA ;
Berger, M .
JOURNAL OF BONE AND MINERAL RESEARCH, 2000, 15 (04) :721-739