Risk of osteoporotic fracture in a large population-based cohort of patients with rheumatoid arthritis.
Risk of osteoporotic fracture in a large population-based cohort of patients with rheumatoid arthritis.
复制标题
DOI：
10.1186/ar3107
复制
发表时间：
2010
影响因子：
4.9
通讯作者：
Solomon DH
中科院分区：
文献类型：
--
作者：
Kim SY;Schneeweiss S;Liu J;Daniel GW;Chang CL;Garneau K;Solomon DH
虽然骨质疏松症在类风湿性关节炎（RA）患者中更常见，但这些患者发生骨质疏松性骨折的风险是否因年龄、性别和解剖部位而异尚不清楚。使用卫生保健利用数据库进行回顾性队列研究。计算骨折的发生率（IR）和率比（RR）及其95%置信区间（CI）。多变量考克斯比例风险模型比较了RA和非RA患者典型部位的桡骨骨折风险。在中位1.63年的随访中，47，034例RA患者中有872例（1.9%）发生骨折。类风湿关节炎患者典型部位骨质疏松性骨折的发病率为9.6/1000人年，是非类风湿关节炎患者发病率的1.5倍。在RA中，髋部骨折的IR最高（3.4/1000人-年）。在所有年龄组中，女性的IR均高于男性，并且两组中的IR均随着年龄的增长而增加。RA患者中所有常见骨折部位的RR均升高：髋关节（1.62，95% CI 1.43 - 1.84）、腕关节（1.15，95% CI 1.00 - 1.32）、骨盆（2.02，95% CI 1.77 - 2.30）和肱骨（1.51，95% CI 1.27 - 1.84）。调整混杂因素后，RA患者骨折风险适度增加（风险比1.26，95%CI 1.15 - 1.38）。我们的研究显示，与非RA患者相比，所有年龄组、性别和不同解剖部位的RA患者发生桡骨骨折的风险增加。
Although osteoporosis has been reported to be more common in patients with rheumatoid arthritis (RA), little is known whether the risk of osteoporotic fractures in these patients differs by age, sex, and anatomic site. A retrospective cohort study was conducted using a health care utilization database. Incidence rates (IRs) and rate ratios (RRs) of osteoporotic fractures with 95% confidence intervals (CIs) were calculated. Multivariable Cox proportional hazards models compared the risk of osteoporotic fracture at typical sites between RA and non-RA patients. During a median 1.63-year follow-up, 872 (1.9%) of 47,034 RA patients experienced a fracture. The IR for osteoporotic fracture at typical sites among RA patients was 9.6 per 1,000 person-years, 1.5 times higher than the rate of non-RA patients. The IR was highest for hip fracture (3.4 per 1,000 person-years) in RA. The IRs across all age groups were higher for women than men and increased with older age in both groups. The RRs were elevated in RA patients across all common sites of osteoporotic fracture: hip (1.62, 95% CI 1.43 to 1.84), wrist (1.15, 95% CI 1.00 to 1.32), pelvis (2.02, 95% CI 1.77 to 2.30), and humerus (1.51, 95% CI 1.27 to 1.84). After confounding adjustment, a modest increase in risk for fracture was noted with RA (hazard ratio 1.26, 95% CI 1.15 to 1.38). Our study showed an increased risk of osteoporotic fractures for RA patients across all age groups, sex and various anatomic sites, compared with non-RA patients.
登录
查看更多内容
影响因子：
--
作者：
Haugeberg, G;Strand, A;Kirwan, JR
通讯作者：
Kirwan, JR
影响因子：
4
作者：
Koh, JM;Khang, YH;Kim, GS
通讯作者：
Kim, GS
影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
影响因子：
3.4
作者：
Coulson, Kathryn A.;Reed, George;Pepmueller, Peri H.
通讯作者：
Pepmueller, Peri H.
影响因子：
4
作者：
Maugeri, D;Russo, MS;Malaguarnera, M
通讯作者：
Malaguarnera, M