患有原发性阿尔多斯特隆症的患者的部骨折 - 瑞典全国性的研究
Eleftheria Gkaniatsa1,2, Tatiana Zverkova Sandström3, Annika Rosengren4,5
1Department of Endocrinology, Sahlgrenska University Hospital, 413 46, Gothenburg, Sweden. eleftheria.gkaniatsa@vgregion.se.
概括
患有原发性阿尔多斯特隆症 (PA) 的患者面临更高的关节骨折风险,特别是女性和老年人. 用矿物质皮质类受体抗剂 (MRA) 治疗与骨折风险增加有关,而上腺切除术可能具有保护作用.
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:
- 原发性阿尔多斯特主义 (PA) 与骨质稳定性障碍有关.
- 以前的研究表明,PA和骨质疏松症之间存在潜在的关联.
- 评估PA患者部骨折发生率对于了解骨健康影响至关重要.
研究的目的:
- 为了确定被诊断为初级阿尔多斯特主义的患者部骨折的发生率.
- 为了比较PA患者的关节骨折风险与来自普通人群的匹配对照.
主要方法:
- 一项全国性的队列研究包括2419名PA患者和24187名匹配的对照 (1997-2019).
- 使用来自瑞典国家患者登记册的ICD代码来识别骨折.
- 风险比率 (HRs) 根据各种风险因素进行调整,包括先前的骨折,社会经济地位,糖尿病,骨质疏松症,甲状腺功能障碍和心血管疾病 (CVD).
主要成果:
- 与对照组相比,PA患者的部骨折风险增加了55% (HR 1.55).
- 在女性 (HR 1.76),56岁以上的患者 (HR 1.62) 和已有心血管疾病患者 (HR 2.15) 中观察到较高的风险.
- 矿物甲基皮质类受体抗剂 (MRA) 治疗与较高的骨折风险相关 (HR 1.84),而上腺切除术没有增加风险 (HR 0.84).
结论:
- 主要的阿尔多斯特主义显著增加关节骨折的风险.
- 特定的子组,包括妇女,老年患者和心血管疾病患者,面临特别高的风险.
- 治疗MRA可能会增加骨折风险,而上腺切除术可以保护PA患者免受部骨折.
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