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World Osteoporosis Day 2007 Press Release Information

Osteoporosis is a condition associated with bone fragility and increased risk of bone fractures. This is one of most common and disabling illnesses that are associated with pain, loss of mobility and independency. Many patients died within one year of their fracture. About 1/3 of postmenopausal women and 1/10 of men above the age of 50 have osteoporosis. It is estimated that about 300,000 women and 100,000 men in Hong Kong are currently suffering from osteoporosis. 

Although low BMD is used as for diagnosing osteoporosis, only half of the patients with fracture have BMD values below the diagnostic threshold. Risk factor assessment, in addition to BMD measurement, is increasingly recognized as a reliable predictor of absolute osteoporotic fracture risk. However, Asian-specific data on risk factors for osteoporosis remain sparse The University of Hong Kong had conducted a prospective study to determine the specific independent risk factors for osteoporotic fracture and to predict the 10-yr risk of fracture in the postmenopausal Southern Chinese population.

A total of 1435 community-dwelling, postmenopausal, treatment-naive women were recruited. Baseline demographic characteristics and clinical risk factors were obtained, and BMD at the spine and hip was measured. Subjects were followed for outcomes of low trauma fracture. Ten-year risk of osteoporotic fracture was predicted from the risk factor assessment and BMD measurement.

 The mean age of subjects was 63 yr. After an average follow-up period of 5yr (range, 1.0-11.0 yr) of follow-up, 80 non-traumatic new fractures were reported. Eight independent clinical risk factors identified at baseline were found to be significant predictors of osteoporotic fracture, with the most important being use of walking aids (4.2-fold increased risk) and a history of fall (4-fold increased risk). Other predictive factors included being homebound, calcium intake < 400 mg/day, age > 65 yr, history of fracture, and BMI < 19 kg/cm2. Subjects with three to eight clinical risk factors had a predicted 10-year risk of fracture of 25%, which increased to 30% if they also had total hip BMD T-score

In conclusion, clinical risk factor assessment, in addition to BMD measurement, is a reliable predictor of 10-year risk of osteoporotic fracture.

骨質疏鬆症會令骨質密度降低,骨頭容易折斷,是世界上最常見及令人虛弱的疾病之一。此病可引致疼痛、失去活動能力及自理能力,而且多會致命。三分之一的50歲以上女性及五分之一的50歲以上男性會患骨質疏鬆性骨折。隨著人口擴張及老化,患上骨質疏鬆的人數日益增多,估計香港現時有30萬名絶經婦女及10萬名50歲以上的男士患有骨質疏鬆症。

骨質疏鬆症在某程度上是可以預防的,而且診斷十分簡易,市面上亦有多種有效治療。為了理解引起骨折的因素,香港大學為1,435名已收經的婦女進行了一項追蹤性研究。她們的平均年齡為63歲。她們接受了一系列的評估,包括量度骨質密度及一些臨床風險評估。個案被跟進了1至11年,平均追蹤期為5年。在跟進期間中有80名婦女出現骨折。其中8個最重要的骨折高危因素為:摔倒、使用助行器具、足不出戶、每天戶外步行少於30分鐘、鈣質攝取量每天低於400毫克、年歲大於65歲、有過往骨折紀錄、體重過瘦(身體指標低於19)。有超過三個以上高危因素者其十年內骨折風險為百分之二十五,又如果她們的骨質密度T值低於 -2.5,其十年的骨折風險將提升到百分之三十。這研究的數據引證了臨床高危因素及骨質密度測試能有效預測十年骨折風險。