JCEM：中山大学陈裕明等发现高脂饮食增加髋关节骨折的发生

很多研究探讨个体饮食或营养对骨骼健康的影响，但很少的研究关注饮食模式。为了调查在中国老年人，饮食模式与髋关节骨折风险的关系，来自中山大学公共卫生学院的陈裕明教授及其团队进行了一项研究，该研究发现一个健康的或谨慎的饮食模式消费可以预防髋关节骨折，反之，高脂饮食模式增加这类骨折的发病率。该研究结果在线发表在2013年4月12日的美国《临床内分泌代谢杂志》（The journal of clinical endocrinology & metabolism）上。

该研究是2009年6月至2012年7月期间，在中国广东省进行的，年龄（±3岁）和性别1：1配对的病例对照研究。共有581对髋关节骨折病例和对照者（71+/-7岁）被研究。使用75项食物频率问卷进行面对面访谈评估饮食摄入量，而基本资料使用结构式问卷收集。饮食模式通过主成分因素分析确定。使用单变量和多变量条件logistic回归分析相关性。

该研究结果表明，研究确定了4中饮食模式：健康，谨慎，传统和高脂。该研究观察到髋关节骨折风险剂量依赖性的的减少与高水果和蔬菜摄入有关的较高分值的健康饮食模型，及摄入更多坚果、蕈类、藻类和海鲜，以及更少谷类为代表的谨慎饮食模型有关，然而，同样与较低分值的高脂饮食模型有关（所有P＜0.05）。三种饮食模型的最大三分位数比较，髋关节骨折的校正ORs（95%CI）为：健康饮食0.42（0.24–0.73），谨慎饮食0.51（0.28–0.90），以及高脂饮食2.25（1.38–3.69）。在传统饮食模型（中国花草茶，老火汤，加工肉类和鱼类，动物脏器）与髋关节骨折风险之间没有发现有意义的相关。

该研究发现，一个健康的或谨慎的饮食模式消费可以预防髋关节骨折，反之，高脂饮食模式增加这类骨折的发病率。

与骨折相关的拓展阅读：

• 2013AAOS：全髋置换治疗切开复位内固定术后失败的髋臼骨折
• 2013AAOS：锁骨骨折进行性移位的临床观察
• 2013AAOS：不同年龄段幼儿肱骨髁上移位骨折的临床特征差异
• Injury：关节外胫骨远端骨折的手术选择：MIPPO vs ORIF
• AAOS：多次细菌培养或可提高骨折内固定术后感染诊断率
• AAOS：抗骨质疏松治疗可降低髋部骨折老年女性的死亡风险
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Dietary patterns and the risk of hip fractures in elderly Chinese: A matched case-control study.
Context
Many studies have investigated the effects of individual foods or nutrients on bone health, but limited research has focused on dietary patterns.Purpose:We examined the association of dietary patterns with the risk of hip fractures in elderly Chinese.
Design
This 1:1 age- (±3 y) and gender-matched case-control study were performed between June 2009 and June 2012.
Setting
The study was conducted in Guangdong Province, China.
Participants
A total of 581 pairs of hip fracture incident cases and controls (71+/-7 y) were studied. Face-to-face interviews were conducted to assess dietary intake using a 79-item food frequency questionnaire, while general information was collected using structured questionnaires. Dietary patterns were identified by principal components factor analysis. Univariate and multivariate conditional logistic regression were used to analyze the association.
Main result
We identified four dietary patterns: healthy, prudent, traditional, and high fat. Dose-dependent lower risks of hip fracture were observed in relation to higher scores in the healthy dietary pattern related to high fruit and vegetable intake, and in the prudent pattern typified by a higher intake of nuts, mushrooms, algae, and seafood but lower in grains, whereas the same were associated with lower scores in the high fat dietary pattern (all P trend <0.05). The adjusted ORs (95% CIs) for hip fractures, comparing the extreme tertiles of the three patterns, were 0.42 (0.24-0.73) for healthy, 0.51 (0.28-0.90) for prudent, and 2.25 (1.38-3.69) for high fat. No significant association was found between the traditional dietary pattern (with a high intake of Chinese herbal tea, double-stewed soup, processed meat and fish, organ meat) and hip fracture risk.
Conclusions
Our findings suggest that the consumption of a healthy or prudent dietary pattern can protect against hip fractures, whereas a high fat pattern promotes the incidence of such fractures.