人口及社会经济因素与髋骨骨折风险的病例对照研究  

Relationship between demographic and socioeconomic factors and the risk of hip fractures: a case-control study

作　　者：樊帆[1] 涂素兰[2] 薛文琼[1] 吴宝华 欧阳维富[4] 谢海丽[1] 陈裕明[1] 

机构地区：[1]中山大学公共卫生学院医学统计与流行病学系,广州510080 [2]广东省江门市白石正骨医院 [3]广州市越秀区正骨医院 [4]广东省人民医院

出　　处：《中国骨质疏松杂志》2013年第8期844-849,共6页Chinese Journal of Osteoporosis

基　　金：国家自然科学基金(30872100;81072299)

摘　　要：目的探讨老年人社会经济因素与髋骨骨折的关系。方法采用1∶1配对的病例对照研究方法,收集2009年6月-2012年6月在广东省4所医院就诊的581名55～80岁新发髋骨骨折患者作为病例,同期招募性别、年龄(+/-3岁)匹配的广州市社区居民或非骨科相关疾病的病人作为对照。通过面对面访问调查其人口学特征及社会经济学情况。结果单因素条件logistic回归分析显示,已婚、文化程度高、职业体力活动低、收入和社会地位高、城镇居民及近5年经济状况好可降低髋骨骨折风险。在年龄、家族史及社会经济因素间相互校正后,婚姻状况、当前家庭人均收入及近5年经济状况的影响仍具有统计学意义。已婚者髋骨骨折风险是未婚、离异或丧偶者的0.44(95%CI:0.29～0.64)倍;家庭月收入最高组是最低组的0.26(95%CI:0.09～0.77)倍;近5年经济状况较好者风险是较差者的0.32(0.15～0.70)倍。分层和交互作用分析发现,近5年经济状况的影响在男性中更为明显(交互作用P=0.053)。结论社会经济状况较差及无配偶易增加髋骨骨折风险。Objective To investigate the relationship between demographic and socioeconomic factors and hip fractures. Methods 1：1 matched case-control method was adopted. A total of 581 patients aging from 55 to 80 years old, who had new hip fractures and came to the 4 hospitals in Guangdong Province from June 2009 to June 2012, were enrolled in this study. At the same time, citizens in Guangzhou or patients without bone diseases, matched by gender and age （ ＋ 3 years） , were recruited as controls. Demographic characteristic and socioeconomic status were collected through face-to-face interview. Results Univariate logistic regression analysis showed significantly lower risks of hip fractures in subjects being married, with high level of education, household income, social status, and economic status within 5 years, and lower level of occupational physical activity. After adjustment for potential confounders （age, family history, and socioeconomic factors）, the effect of the risks of hip fractures remained significant with marital status, household income, and economic status within 5 years. The risk of hip fractures was 0. 44 （95% CI： 0. 29 -0. 64） folds in subjects being married compared with those in divorced, widowed, or unmarried ones. The risk in subjects with the highest household income was 0.26 （95% CI： 0. 09-0. 77） times compared with that in subjects with the lowest household income. And the risk in those with good economic status within 5 years was 0. 32 （95% CI： 0. 15-0. 70） times compared with that in those with poor ones. Stratified and interaction analysis showed that the effect of economic status was more significant in the male than that in thefemale （P-interaction = O. 053）. Conclusion The risk of hip fractures increases in subjects with poor socioeconomic status or unmarried.

关 键 词：髋骨骨折 社会经济因素 病例对照 

分 类 号：R181.32[医药卫生—流行病学]