Assessment of Sex Differences in Fracture Risk Among Patients With Anorexia Nervosa: A Population-Based Cohort Study Using The Health Improvement Network
Assessment of Sex Differences in Fracture Risk Among Patients With Anorexia Nervosa: A Population-Based Cohort Study Using The Health Improvement Network
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DOI：
10.1002/jbmr.3068
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发表时间：
2017-05-01
影响因子：
6.2
通讯作者：
Denburg, Michelle R.
中科院分区：
文献类型：
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作者：
Nagata, Jason M.;Golden, Neville H.;Denburg, Michelle R.
虽然以前的研究已经证明了女性神经性厌食症（AN）骨折的风险增加，但男性骨折的风险并没有得到很好的表征。本研究的目的是检查AN中骨折风险和特定部位骨折发生率的性别差异。我们使用健康改善网络（THIN;在英国各地的初级保健诊所收集的匿名电子病历的大型数据库）进行了一项基于人群的回顾性队列研究。观察期开始的中位日历年为2004-2005年。我们确定了9239名40岁的女性和556名40岁的男性（HR，2.54; 95%CI，1.32至4.90; p=0.005），但40岁的男性中没有。AN的女性几乎在所有解剖部位都有较高的骨折风险。最大的过度骨折风险出现在女性的髋关节/股骨（HR，5.59; 95% CI，3.44 - 9.09）和骨盆（HR，4.54; 95% CI，2.42 - 8.50），以及AN男性的椎骨（HR，7.25; 95% CI，1.21 - 43.45）。在所有年龄组的女性和>40岁的男性中，AN与较高的骨折风险相关。骨折风险最高的部位包括女性的髋关节/股骨和骨盆以及AN男性的椎骨。(c)2016年美国骨与矿物质研究学会。
Though previous studies have demonstrated an increased fracture risk in females with anorexia nervosa (AN), fracture risk in males is not well characterized. The objective of this study was to examine sex differences in fracture risk and site-specific fracture incidence in AN. We performed a population-based retrospective cohort study using The Health Improvement Network (THIN; a large database of anonymized electronic medical records collected at primary care clinics throughout the United Kingdom). The median calendar year for the start of the observation period was 2004-2005. We identified 9239 females and 556 males 40 years of age (HR, 2.54; 95% CI, 1.32 to 4.90; p=0.005) but not among males 40 years. Females with AN had a higher risk of fracture at nearly all anatomic sites. The greatest excess fracture risk was noted at the hip/femur (HR, 5.59; 95% CI, 3.44 to 9.09) and pelvis (HR, 4.54; 95% CI, 2.42 to 8.50) in females and at the vertebrae (HR, 7.25; 95% CI, 1.21 to 43.45) for males with AN. AN was associated with higher incident fracture risk in females across all age groups and in males >40 years old. Sites of highest fracture risk include the hip/femur and pelvis in females and vertebrae in males with AN. (c) 2016 American Society for Bone and Mineral Research.