Ty - jour
T1 -健康老年人血浆高密度脂蛋白胆固醇水平与骨折风险的关系
AU - Hussain, Sultana Monira
欧贝林，彼得·R。
AU - Barker, Anna L。
欧贝林，劳伦斯。
AU - Tonkin, Andrew M.;
AU -麦克尼尔，约翰。
N1 -出版商版权所有:©2023美国医学协会。版权所有。
Py - 2023/3/8
Y1 - 2023/3/8
重要性:高密度脂蛋白胆固醇(HDL-C)水平升高与骨质疏松症有关。临床前研究报告HDL-C通过减少成骨细胞数量和功能来降低骨密度。然而，这些发现的临床意义尚不清楚。目的:确定高HDL-C水平是否预示着健康老年人骨折风险的增加。设计、环境和参与者:本队列研究是对阿司匹林减少老年人事件(ASPREE)临床试验和ASPREE-骨折亚研究数据的事后分析。ASPREE是一项双盲、随机、安慰剂对照的阿司匹林一级预防试验，在2010年至2014年期间招募了参与者。这些研究对象包括基于社区的老年人(16703名≥70岁的澳大利亚人，2411名≥65岁的美国人)，没有明显的心血管疾病、痴呆、身体残疾和限制生命的慢性疾病。aspre -骨折亚研究收集了澳大利亚参与者随机化后报告的骨折数据。Cox回归计算风险比(HR)和95% CI。本研究的数据分析于2022年4月至8月进行。 Exposure: Plasma HDL-C. Main Outcomes and Measures: Fractures included were confirmed by medical imaging and included both traumatic and minimal trauma fractures. Fractures were adjudicated by an expert review panel. Results: Of the 16262 participants who had a plasma HDL-C measurement at baseline (8945 female participants [55%] and 7319 male [45%]), 1659 experienced at least 1 fracture over a median (IQR) of 4.0 years (0.02-7.0 years). In a fully adjusted model, each 1-SD increment in HDL-C level was associated with a 14% higher risk of fractures (HR, 1.14; 95% CI, 1.08-1.20). The results remained similar when these analyses were stratified by sex. Sensitivity and stratified analyses demonstrated that these associations persisted when the analyses were repeated to include only (1) minimal trauma fractures, (2) participants not taking osteoporosis medications, (3) participants who were never smokers and reported that they did not drink alcohol, and (4) participants who walked outside for less than 30 minutes per day and reported no participation in moderate/vigorous physical activity and to examine only (5) statin use. No association was observed between non-HDL-C levels and fractures. Conclusions and Relevance: This study suggests that higher levels of HDL-C are associated with an increased fracture risk. This association was independent of common risk factors for fractures.
重要性:高密度脂蛋白胆固醇(HDL-C)水平升高与骨质疏松症有关。临床前研究报告HDL-C通过减少成骨细胞数量和功能来降低骨密度。然而，这些发现的临床意义尚不清楚。目的:确定高HDL-C水平是否预示着健康老年人骨折风险的增加。设计、环境和参与者:本队列研究是对阿司匹林减少老年人事件(ASPREE)临床试验和ASPREE-骨折亚研究数据的事后分析。ASPREE是一项双盲、随机、安慰剂对照的阿司匹林一级预防试验，在2010年至2014年期间招募了参与者。这些研究对象包括基于社区的老年人(16703名≥70岁的澳大利亚人，2411名≥65岁的美国人)，没有明显的心血管疾病、痴呆、身体残疾和限制生命的慢性疾病。aspre -骨折亚研究收集了澳大利亚参与者随机化后报告的骨折数据。Cox回归计算风险比(HR)和95% CI。本研究的数据分析于2022年4月至8月进行。 Exposure: Plasma HDL-C. Main Outcomes and Measures: Fractures included were confirmed by medical imaging and included both traumatic and minimal trauma fractures. Fractures were adjudicated by an expert review panel. Results: Of the 16262 participants who had a plasma HDL-C measurement at baseline (8945 female participants [55%] and 7319 male [45%]), 1659 experienced at least 1 fracture over a median (IQR) of 4.0 years (0.02-7.0 years). In a fully adjusted model, each 1-SD increment in HDL-C level was associated with a 14% higher risk of fractures (HR, 1.14; 95% CI, 1.08-1.20). The results remained similar when these analyses were stratified by sex. Sensitivity and stratified analyses demonstrated that these associations persisted when the analyses were repeated to include only (1) minimal trauma fractures, (2) participants not taking osteoporosis medications, (3) participants who were never smokers and reported that they did not drink alcohol, and (4) participants who walked outside for less than 30 minutes per day and reported no participation in moderate/vigorous physical activity and to examine only (5) statin use. No association was observed between non-HDL-C levels and fractures. Conclusions and Relevance: This study suggests that higher levels of HDL-C are associated with an increased fracture risk. This association was independent of common risk factors for fractures.
UR - http://www.scopus.com/inward/record.url?scp=85148857388&partnerID=8YFLogxK
U2 - 10.1001/jamacardio.2022.5124
DO - 10.1001/jamacardio.2022.5124
M3 -物品
C2 - 36652261
安- scopus:85148857388
Vl - 8
Sp - 268
Ep - 272
JAMA心脏病学
JF - JAMA心脏病学
Sn - 2380-6583
Is - 3
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