在Graves病中骨折发生率:基于人口的研究
Selwan Khamisi1,2, Ruzan Udumyan3, Gabriel Sjölin4,5
1Department of Endocrinology and Diabetes, Uppsala University Hospital, Uppsala, Sweden.
Thyroid : official journal of the American Thyroid Association
|September 19, 2023
概括
格雷夫斯病 (GD) 患者没有显示整体骨折风险增加. 然而,患有GD的老年男性的脊椎骨折率更高,表明需要有针对性的骨健康监测.
科学领域:
- 内分泌学 在内分泌学.
- 骨的新陈代谢 骨的新陈代谢
- 流行病学 流行病学
背景情况:
- 甲状腺功能障碍,特别是格雷夫斯病 (GD),与增加骨周转率和潜在的骨矿物质密度损失有关.
- 之前的人口研究显示,甲状腺功能高患者骨折风险的结果不一,需要进一步调查.
- 格雷夫斯病是甲状腺功能障碍的最常见原因,使其成为了解骨健康影响的关键焦点.
研究的目的:
- 为了研究被诊断为格雷夫斯病的患者的特定骨折风险.
- 分析骨并发症风险,包括骨折,在一个大队伍的GD患者.
- 为了比较GD患者和来自一般人群的匹配对照之间的骨折率.
主要方法:
- 追溯队列研究设计,使用瑞典国家登记册来获取患者数据和药物/治疗信息.
- 包括2,134名发生格雷夫斯病患者和21,261名匹配的对照,在诊断后16-18年内进行跟踪.
- 使用Cox比例危险模型进行统计分析,以估计骨折风险的危险比率 (HR) 和置信区间 (CI).
主要成果:
- 在Graves病患者和对照人群之间没有观察到总骨折率的显著整体差异.
- 经过调整的分析显示,52岁以上的男性GD患者的脊椎骨折率显著更高 (HR = 2.83).
- 格雷夫斯病患者接受了更多的骨质疏松症和皮质类固醇治疗,但这些并不能完全解释观察到的骨折风险差异.
结论:
- 与对照组相比,在一般的格雷夫斯病患者群体中,总骨折风险并不高.
- 患有格雷夫斯病的老年男性患者表现出脊椎骨折的风险增加.
- 接受治疗的格雷夫斯病患者比普通人群更有可能接受骨质疏松症治疗.
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