hip fracture incidence in relation to age, menopausal status, and age at menopause prospective analysis髋部骨折发生率与年龄、绝经情况,绝经的年龄前瞻性分析.pdfVIP

Hip Fracture Incidence in Relation to Age, Menopausal Status, and Age at Menopause: Prospective Analysis 1 2 2 2 2 2 Emily Banks *, Gillian K. Reeves , Valerie Beral , Angela Balkwill , Bette Liu , Andrew Roddam , for the Million Women Study Collaborators 1 National Centre for Epidemiology and Population Health, The Australian National University, Acton, Australia, 2 Cancer Research UK Epidemiology Unit, University of Oxford, Oxford, United Kingdom Abstract Background: Bone mineral density is known to decrease rapidly after the menopause. There is limited evidence about the separate contributions of a woman’s age, menopausal status and age at menopause to the incidence of hip fracture. Methods and Findings: Over one million middle-aged women joined the UK Million Women Study in 1996–2001 providing information on their menopausal status, age at menopause, and other factors, which was updated, where possible, 3 y later. All women were registered with the UK National Health Service (NHS) and were routinely linked to information on cause- specific admissions to NHS hospitals. 561,609 women who had never used hormone replacement therapy and who provided complete information on menopausal variables (at baseline 25% were pre/perimenopausal and 75% postmenopausal) were followed up for a total of 3.4 million woman-years (an average 6.2 y per woman). During follow- up 1,676 (0.3%) were admitted to hospital with a first incident hip fracture. Among women aged 50–54 y the relative risk (RR) of hip fracture risk was significantly higher in postmenopausal than premenopausal women (adjusted RR 2.22, 95% confidence interval [CI] 1.22–4.04; p = 0.009); there were too few premenopausal