慢性脏疾病中部和脊椎骨折的危险因素:CRIC研究
Simon Hsu1, Nisha Bansal1, Michelle Denburg2,3
1Division of Nephrology and Kidney Research Institute, Department of Medicine, University of Washington, Seattle, WA 98195, United States.
概括
在慢性病 (CKD) 中,骨折风险较高. 较低的功能,糖尿病和较高的副甲状腺激素水平增加骨折风险,突出了潜在的可修改因素.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 整形外科 整形外科 整形外科
- 流行病学 流行病学
背景情况:
- 与普通人群相比,慢性病 (CKD) 患者的骨折风险明显高.
- 在CKD中骨折的潜在原因和特定风险因素可能与非CKD人群中的不同.
研究的目的:
- 研究各种风险因素之间的关联以及部或脊椎骨折的发生率在患有CKD的患者队列中.
- 确定与该人群中骨折风险增加相关的特定临床和生化标志物.
主要方法:
- 进行了一项对3939名慢性功能缺陷队列 (CRIC) 参与者的队列研究.
- 考克斯回归分析用于评估基线和时间更新的风险因素与部或脊椎骨折的关联.
- 使用医院出院代码识别骨折,平均随访时间为11.1年.
主要成果:
- 较低的估计膜过率 (eGFR),糖尿病,较低的体重指数 (BMI),类固醇使用,蛋白尿和副甲状腺激素 (PTH) 升高与骨折风险增加有关.
- 较低的时间更新血清和二碳酸盐度也与较高的骨折发病率有关.
- 用透析治疗的功能衰竭显示出最高的骨折风险 (HR 4.53),其次是移植后 (HR 2.48),相比之下,eGFR ≥60.
结论:
- 降低功能 (较低的EGFR) 是慢性病患者骨折的重要风险因素,在衰竭中观察到的风险最高.
- 包括糖尿病,低BMI,类固醇使用,蛋白尿,高PTH和低/碳酸盐水平在内的几个因素与骨折有关,可能代表干预的可修改目标.
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