Risk Factors Associated with the First Osteoporotic Fracture

첫 번째 골다공성 골절에 영향을 미치는 요인

  • 김영선 (광주기독병원) ;
  • 최자윤 (전남대학교 간호대학.간호과학연구소)
  • Received : 2011.08.08
  • Accepted : 2011.12.08
  • Published : 2011.12.31

Abstract

Purpose: The purposes of this study were to identify the factors associated with the first reported fracture in osteoporotic patients. Methods: One hundred and sixty-four patients who presented with osteoporosis at K hospital in G city, South Korea between July and September 2010 were participated in study. Modified Korea National Health and Nutrition Examination Survey tool were used to measure participants' living habits. Computer aided nutritional analysis program (CAN-PRO) designed by Nutrition Information Center in the Korean Nutrition Society (2002) was used to analyze foods intake and to calculate the individual nutrients intake. Results: The risk of developing the first osteoporotic fracture was ten times higher in the patients between 65 to 74 years (OR=10.06, p=.010), and 28.41 times greater in those with increasing falls (OR=28.41, p<.001). Patients with higher bone marrow density (BMD) and higher consumption of animal protein diet had lower risks of developing the first osteoporotic fracture (OR=0.37, p=.011; OR=0.88, p=.040, respectively). Conclusion: Risk factors for osteoporotic fracture included the age from 65 to 74 years, an increase in falls, low animal protein consumption, and reduced BMD. Systematic educational program is needed to prevent fracture in osteoporotic patients.

Keywords

References

  1. Barzel, U. S. (1995). The skeleton as an ion exchange system: Implications for the role of acid-base imbalance in the genesis of osteoporosis. Journal of Bone and Mineral Research, 10, 1431-1436.
  2. Bonjour, J. P. (2005). Dietary protein: An essential nutrient for bone health. Journal of the American College of Nutrition, 24, 526S-536S.
  3. Bow, C. H., Tsang, S. W. Y., Loong, C. H. N., Soong, C. S. S., Yeung, S. C., & Kung, A. W. C. (2011). Bone mineral density enhances use of clinical risk factors in predicting ten-year risk of osteoporotic fractures in Chinese men: The Hong Kong osteoporosis study. Osteoporosis International, Advanced Online Publication. doi:10.1007/s00198-010-1490-0
  4. Dawson-Hughes, B., & Harris, S. S. (2002). Calcium intake influences the association of protein intake with rates of bone loss in elderly men and women. The American Journal of Clinical Nutrition, 75, 773-779.
  5. Erdfelder, E., Faul, F., & Buchner, A. (1996). GPOWER: A general power analysis program. Behavior Research Methods, Instruments & Computers, 28, 1-11. https://doi.org/10.3758/BF03203630
  6. Faulkner, K. A., Chan, B. K. S., Cauley, J. A., Marshall, L. M., Ensurd, K. E., Stefanick, M. L., et al. (2009). Histories including number of falls may improve risk prediction for certain non-vertebral fractures in older men. Injury Prevention, 15, 307-311. doi:10.1136/ip.2009.021915
  7. Hannan, M. T., Tucker, K. L., Dawson-hughes, B., Cupples, L. A., Felson, D. T., & Kiel, D. P. (2000). Effect of dietary protein on bone loss in elderly men and women: The Framingham osteoporosis study. Journal of Bone and Mineral Respiration, 15, 2504-2512.
  8. Health Insurance Review and Assessment Service. (2010, February). Health service use and pharmacological prescription of osteoporosis 2009-2008. Seoul: Health Insurance Review and Assessment Service.
  9. Johnell, O., & Kanis, J. A. (2006). An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporosis International, 17, 1726-1733. doi: 10.1007/s00198-006-0172-4
  10. Kanis, J. A., Black, D., Cooper, C., Dargent, P., Dawson-Hughes, B., De Laet, C., et al. (2002). A new approach to the development of assessment guidelines for osteoporosis. Osteoporosis International, 13, 527-536.
  11. Kanis, J. A., Borgstrom, F., De Laet, C., Johansson, H., Johnell, O., Jonsson, B., et al. (2005). Assessment of fracture risk. Osteoporosis International, 16, 581-589.
  12. Kanis, J. A., Johnell, O., Oden, A., Johansson, H., & McCloskey, E. (2008). FRAXTM and the assessment of fracture probability in men and women from the UK. Osteoporosis International, 19, 385-397. doi:10.1007/s00198-007-0543-5
  13. Korea Centers for Disease Control & Prevention. (2009). Korea national health and nutrition examination survey 2008. Retrieved October 10, 2010 from http://knhanes.cdc.go.kr
  14. Lee, S. H., Khang, Y. H., Lim, K. H., Kim, B. J., Koh, J. M., Kim G. S., et al. (2010). Clinical risk factors for osteoporotic fracture: A population-based prospective cohort study in Korea. Journal of Bone and Mineral Research, 25, 369-378. doi:10.1359/jbmr.090722
  15. Meyer, H. E., Pedersen, J. I., Loken, E. B., & Tverdal, A. (1997). Dietary factors and the incidence of hip fracture in middleaged Norwegians: A prospective study. American Journal of Epidemiology, 145, 117-123.
  16. Munger, R. G., Cerhan, J. R., & Chiu, B. C. (1999). Prospective study of dietary protein intake and risk of hip fracture in postmenopausal women. The American Journal of Clinical Nutrition, 69, 147-152.
  17. NIH consensus development panel on osteoporosis prevention, diagnosis, and therapy [NIH]. (2001). Osteoporosis prevention, diagnosis, and therapy. Journal of American Medical Association, 285, 785-795.
  18. Pinheiro, M. M., Ciconelli, R. M., Martini, L. A., & Ferraz, M. B. (2009). Clinical risk factors for osteoporotic fractures in Brazilian women and men: The Brazilian osteoprosis study (BRAZOS). Osteoporosis International, 20, 309-408. doi: 10.1007/s00198-008-068005
  19. Pinheiro, M. M., dos Reis Neto, E. T., Machado, F. S., Omura, F., Yang, J. H. K., Szejnfeld, J., et al. (2010). Risk factors for osteoporotic fractures and low bone density in pre and postmenopausal women. Revista de Saude Publica, 44, 479-485.
  20. Promislow, J. H., Goodman-Gruen, D., Slymen, D. J., & Barrett- Connor, E. (2002). Protein consumption and bone mineral density in the elderly: The Rancho Bernardo Study. American Journal of Epidemiology, 155 , 636-644.
  21. Saunders, J. B., Aasland, O. G., Babor, T. F., de la Fuente, J. R., & Grant, M. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collborative project on early detection of persons with harmful alcohol consumption--II. Addiction, 88, 791-804.
  22. Schurch, M. A., Rizzoli, R., Slosman, D., Vadas, L., Vergnaud, P., & Bonjour, J. P. (1998). Protein supplements increase serum insulin-like growth factor-I levels and attenuate proximal femur bone loss in patients with recent hip fracture: A randomized, double-blind, placebo-controlled trial. Annals of International Medicine, 128, 801-809.
  23. Sellmeyer, D. E., Stone, K. L., Sebastian, A., & Cummings, S. R. (2001). A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women. The American Journal of Clinical Nutrition, 73, 118-122.
  24. Stone, K. L., Seeley, D. G., Lui, L. Y., Cauley, J. A., Ensrud, K., Browner, W. S., et al. (2003). BMD at multiple sites and risk of fracture of multiple types: Long-term results from the study of osteoporotic fractures. Journal of Bone and Mineral Respiration, 18, 1947-1954.
  25. Stubbs, B. (2010). Falls in older adult psychiatric inpatients. International psychogeriatrics, 22, 160. doi:10.1017/S1041610209990160
  26. The Korean Nutrition Society. (2005). Recommended dietary allowances for Koreans. Seoul: Joongang.
  27. The Korean Society of Bone Metabolism. (2008). Physician's guide for diagnosis & treatment of osteoporosis. Seoul: The Korean Society of Bone Metabolism.
  28. Walker, J. (2010). The role of the nurse in the management of osteoporosis. British Journal of Nursing, 19, 1243-1247.
  29. Wengreen, H. J., Munger, R. G., West, N. A., Cutler, D. R., Corcoran, C. D., Zhang, J., et al. (2004). Dietary protein intake and risk of osteoporotic fracture in elderly residents of Utah. Journal of Bone and Mineral Research, 19, 537-545.