儿童肥胖与大多数下肢骨折的风险增加有关。
Childhood obesity is associated with increased risk of most lower extremity fractures.
机构信息
Kaiser Los Angeles Medical Center, 4760 Sunset Boulevard, Los Angeles, CA 90027, USA.
出版信息
Clin Orthop Relat Res. 2013 Apr;471(4):1199-207. doi: 10.1007/s11999-012-2621-z.
BACKGROUND
A number of studies have found an increased risk of lower extremity injuries in obese patients. Most studies, however, are unable to provide stable population-based estimates based on the degree of obesity and few assess the risk pertaining to more detailed fracture location in the lower extremities.
QUESTIONS/PURPOSES: We therefore investigated the relationship between obesity and lower extremity fractures in different age and fracture locations in a stable population.
METHODS
This is a population-based, cross-sectional study from the electronic medical records of 913,178 patients aged 2 to 19 years. The body mass index (BMI) for each patient in the cohort was used to stratify patients into five weight classes (underweight, normal weight, overweight, moderate obesity, and extreme obesity) based on BMI for age. Records were assessed for the occurrence of lower extremity fractures for each cohort member. The associations among the five weight classes and specific lower extremity fractures were estimated using multiple logistic regression models and expressed with odds ratios (ORs) and 95% confidence intervals (CIs) using multivariate analysis to adjust for patient demographic variables.
RESULTS
Overweight, moderately obese, and extremely obese patients all had an increased OR of fractures of the foot (OR, 1.14, 1.23, and 1.42, respectively, with 95% CI, 1.04-1.24, 1.12-1.35, and 1.26-1.61, respectively) along with the ankle, knee, and leg (OR, 1.27, 1.28, and 1.51, respectively, with 95% CI, 1.16-1.39, 1.15-1.42, and 1.33-1.72, respectively). The association was strongest in the 6- to 11-year-old age group. We found no association between increasing BMI and increased risk of fractures of the femur and hip.
CONCLUSIONS
Increasing BMI is associated with increased odds of foot, ankle, leg, and knee fractures in children.
LEVEL OF EVIDENCE
Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
背景
多项研究发现肥胖患者下肢受伤的风险增加。然而，大多数研究无法根据肥胖程度提供稳定的基于人群的估计，并且很少评估与下肢更详细骨折部位相关的风险。
问题/目的：因此，我们在一个稳定的人群中研究了肥胖与不同年龄和下肢骨折部位之间的关系。
方法
这是一项基于人群的横断面研究，来自 913178 名 2 至 19 岁患者的电子病历。队列中每位患者的体重指数（BMI）用于根据年龄 BMI 将患者分层为五个体重类别（体重不足、正常体重、超重、中度肥胖和极度肥胖）。评估每个队列成员下肢骨折的发生情况。使用多元逻辑回归模型估计五个体重类别与特定下肢骨折之间的关联，并使用优势比（OR）和 95%置信区间（CI）表示，使用多元分析调整患者的人口统计学变量。
结果
超重、中度肥胖和极度肥胖患者的足部（OR，1.14、1.23 和 1.42，95%CI，1.04-1.24、1.12-1.35 和 1.26-1.61，分别）、踝关节、膝关节和腿部骨折的 OR 均增加（OR，1.27、1.28 和 1.51，95%CI，1.16-1.39、1.15-1.42 和 1.33-1.72，分别）。这种关联在 6 至 11 岁年龄组最强。我们没有发现 BMI 增加与股骨和髋部骨折风险增加之间的关联。
结论
BMI 增加与儿童足部、踝关节、腿部和膝关节骨折的几率增加有关。
证据水平
三级，预后研究。有关证据水平的完整描述，请参阅作者指南。
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