Laxative use and incident falls, fractures and change in bone mineral density in postmenopausal women: results from the Women's Health Initiative.
Laxative use and incident falls, fractures and change in bone mineral density in postmenopausal women: results from the Women's Health Initiative.
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DOI：
10.1186/1471-2318-13-38
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发表时间：
2013-05-01
期刊：
影响因子：
4.1
通讯作者：
Wassertheil-Smoller S
中科院分区：
文献类型：
--
作者：
Haring B;Pettinger M;Bea JW;Wactawski-Wende J;Carnahan RM;Ockene JK;Wyler von Ballmoos M;Wallace RB;Wassertheil-Smoller S
泻药是美国最广泛使用的非处方药之一，但研究其潜在危险副作用的研究很少。泻药的使用与骨折风险和骨矿物质密度（BMD）变化之间的关系以前没有研究过。这项前瞻性分析包括161，808名绝经后妇女（8907名使用者和151，497名未使用泻药），这些妇女参加了WHI观察性研究和临床试验。从1993年10月1日至1998年12月31日，在美国的40个临床中心招募了女性，如果她们年龄在50至79岁之间，并且在招募时已绝经，则有资格参加。在基线和3年随访时，在对每个人的面对面访谈中获得药物清单。使用了自我报告的福尔斯（≥2）、骨折（髋关节和全骨折）数据。在WHI的40个临床中心中的3个在基线和第3年测定BMD。无论使用泻药的时间长短，使用泻药者和不使用泻药者之间髋关节骨折和总骨折的经神经网络校正的发生率相似，但福尔斯的发生率不同。任何泻药使用的多变量校正风险比为：福尔斯1.06（95%置信区间[CI]，1.03-1.10），髋部骨折1.02（95% CI，0.85-1.22），全部骨折1.01（95% CI，0.96-1.07）。服用泻药3年后，服用泻药者和不服用泻药者在任何骨骼部位的BMD水平均无统计学差异。这些发现支持泻药使用与福尔斯风险增加之间的适度关联，但与骨折无关。它的使用不会降低绝经后妇女的骨密度水平。应将维持身体功能以及对容易导致福尔斯跌倒的合并症提供充分的治疗作为避免与使用泻药相关的潜在负面后果的首要措施。
Laxatives are among the most widely used over-the-counter medications in the United States but studies examining their potential hazardous side effects are sparse. Associations between laxative use and risk for fractures and change in bone mineral density [BMD] have not previously been investigated. This prospective analysis included 161,808 postmenopausal women (8907 users and 151,497 nonusers of laxatives) enrolled in the WHI Observational Study and Clinical Trials. Women were recruited from October 1, 1993, to December 31, 1998, at 40 clinical centers in the United States and were eligible if they were 50 to 79 years old and were postmenopausal at the time of enrollment. Medication inventories were obtained during in-person interviews at baseline and at the 3-year follow-up visit on everyone. Data on self-reported falls (≥2), fractures (hip and total fractures) were used. BMD was determined at baseline and year 3 at 3 of the 40 clinical centers of the WHI. Age-adjusted rates of hip fractures and total fractures, but not for falls were similar between laxative users and non-users regardless of duration of laxative use. The multivariate-adjusted hazard ratios for any laxative use were 1.06 (95% confidence interval [CI], 1.03-1.10) for falls, 1.02 (95% CI, 0.85-1.22) for hip fractures and 1.01 (95% CI, 0.96-1.07) for total fractures. The BMD levels did not statistically differ between laxative users and nonusers at any skeletal site after 3-years intake. These findings support a modest association between laxative use and increase in the risk of falls but not for fractures. Its use did not decrease bone mineral density levels in postmenopausal women. Maintaining physical functioning, and providing adequate treatment of comorbidities that predispose individuals for falls should be considered as first measures to avoid potential negative consequences associated with laxative use.
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DOI：
10.2215/cjn.06120809
发表时间：
2010-02-01
影响因子：
9.8
作者：
Kinsella, Sinead;Moran, Sarah;Eustace, Joseph A.
通讯作者：
Eustace, Joseph A.
影响因子：
7.2
作者：
Kallin, K;Gustafson, Y;Karlsson, S
通讯作者：
Karlsson, S
影响因子：
--
作者：
Carbone, Laura D.;Johnson, Karen C.;LaCroix, Andrea Z.
通讯作者：
LaCroix, Andrea Z.
DOI：
10.1111/j.1532-5415.2007.01048.x
发表时间：
2007-02-01
影响因子：
6.3
作者：
Broe, Kerry E.;Chen, Tai C.;Kiel, Douglas P.
通讯作者：
Kiel, Douglas P.
影响因子：
5.9
作者：
Decaux, Guy
通讯作者：
Decaux, Guy