Elevated fracture risk for adults with neurodevelopmental disabilities.
Elevated fracture risk for adults with neurodevelopmental disabilities.
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患有神经发育障碍的成年人骨折风险升高。
DOI：
10.1016/j.bone.2019.115080
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发表时间：
2020-01
期刊：
影响因子：
4.1
通讯作者：
Peterson MD
中科院分区：
文献类型：
--
作者：
Whitney DG;Caird MS;Jepsen KJ;Kamdar NS;Marsack-Topolewski CN;Hurvitz EA;Peterson MD
骨折是一种高负担的疾病，加速了不健康的衰老，并代表了相当大的经济负担。与没有神经发育障碍的成年人相比，患有神经发育障碍（ndd）的成年人在更年轻时可能容易骨折；然而，对于这些服务不足的人群的骨折负担知之甚少。本研究的目的是确定与非ndd的成年人相比，ndd的成人全因骨折的性别分层患病率，以及ndd的共病是否与更高的骨折风险相关。2016年的数据来自Optum Clinformatics®数据集市（私人保险）和Medicare按服务收费（公共保险）随机抽取的20%样本。使用ICD-10-CM诊断代码来识别成人ndd，包括智力残疾、自闭症谱系障碍和脑瘫。比较有NDD和没有NDD的成年人的年龄标准化骨折患病率和按解剖位置划分的骨折患病率，然后比较1型NDD与2型和3型NDD的成年人。与没有ndd的成年人（n= 870万）相比，患有智力残疾（n=69,456）、自闭症谱系障碍（n=21,844）和脑瘫（n=29,255）的成年人骨折发生率更高。女性分别为8.3%、8.1%和8.5%，而女性为3.5%。男性分别为6.6%、5.9%和6.7%对3.0%。与没有ndd的女性相比，患有ndd的女性头颈、胸椎、腰椎/骨盆、上肢和下肢骨折的发生率更高。在男性中也观察到类似的模式，除了所有ndd患者的腰椎/骨盆和自闭症谱系障碍患者的胸椎没有差异。对于女性和男性，NDD合并症的增加与任何骨折的高患病率相关：1 NDD（女性，7.7%；男性，5.7%）；2例ndd（女性9.4%，男性7.2%）；所有3种ndd（女性，11.3%；男性，13.7%）。研究结果表明，与没有NDD的成年人相比，患有NDD的成年人骨折患病率更高，大多数解剖部位的NDD合并症数量更多，骨折风险更高。我们的研究结果表明，有必要对患有ndd的成人进行早期的肌肉骨骼虚弱筛查和预防服务。
Fracture is a high-burden condition that accelerates unhealthful aging and represents a considerable economic burden. Adults with neurodevelopmental disabilities (NDDs) may be susceptible for fracture at younger ages compared to adults without NDDs; and yet, very little is known about the burden of fracture for these underserved populations. The purpose of this study was to determine the sex-stratified prevalence of all-cause fracture among adults with NDDs, as compared to adults without NDDs, and if comorbidity of NDDs is associated with greater risk of fracture. Data from 2016 were extracted from Optum Clinformatics® Data Mart (private insurance) and a random 20% sample from Medicare fee-for-service (public insurance). ICD-10-CM diagnosis codes were used to identify adults with NDDs, including intellectual disabilities, autism spectrum disorders, and cerebral palsy. Age-standardized prevalence of any fracture and fracture by anatomical location was compared between adults with and without NDDs, and then for adults with 1 NDD vs. 2 and 3 NDDs. Adults with intellectual disabilities (n=69,456), autism spectrum disorders (n=21,844), and cerebral palsy (n=29,255) had a higher prevalence of any fracture compared to adults without NDDs (n=8.7 million). For women, it was 8.3%, 8.1%, and 8.5% vs. 3.5%, respectively. For men, it was 6.6%, 5.9%, and 6.7% vs. 3.0%, respectively. Women with NDDs had a higher prevalence of fracture of the head/neck, thoracic, lumbar/pelvis, upper extremities, and lower extremities compared to women without NDDs. A similar pattern was observed for men, except for no difference for lumbar/pelvis for all NDDs and thoracic for autism spectrum disorders. For women and men, increasing comorbidity of NDDs was associated with a higher prevalence of any fracture: 1 NDD (women, 7.7%; men, 5.7%); 2 NDDs (women, 9.4%; men, 7.2%); all 3 NDDs (women, 11.3%; men, 13.7%). Study findings suggest that adults with NDDs have an elevated prevalence of fracture compared to adults without NDDs, with the fracture risk being higher with greater numbers of comorbid NDD conditions for most anatomical locations. Our study findings indicate a need for earlier screening and preventive services for musculoskeletal frailty for adults with NDDs.
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影响因子：
4
作者：
Modlesky, C. M.;Whitney, D. G.;Miller, F.
通讯作者：
Miller, F.
自闭症谱系障碍男性的骨骼应计。
DOI：
10.1016/j.jpeds.2016.10.080
发表时间：
2017-02
期刊：
The Journal of pediatrics
影响因子：
--
作者：
Neumeyer AM;Cano Sokoloff N;McDonnell E;Macklin EA;McDougle CJ;Misra M
通讯作者：
Misra M
影响因子：
5.1
作者：
Johnson, David L.;Miller, Freeman;Modlesky, Christopher M.
通讯作者：
Modlesky, Christopher M.
影响因子：
5.9
作者：
Cremer, Nicole;Hurvitz, Edward A.;Peterson, Mark D.
通讯作者：
Peterson, Mark D.
影响因子：
39
作者：
Neuman, Mark D.;Silber, Jeffrey H.;Werner, Rachel M.
通讯作者：
Werner, Rachel M.