The Epidemiology of Osteoporosis-Bone Evaluation Study (BEST) An Analysis of Routine Health Insurance Data
The Epidemiology of Osteoporosis-Bone Evaluation Study (BEST) An Analysis of Routine Health Insurance Data
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DOI：
10.3238/arztebl.2013.0052
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发表时间：
2013-01-25
影响因子：
7.7
通讯作者：
Linder, Roland
中科院分区：
文献类型：
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作者：
Hadji, Peyman;Klein, Silvia;Linder, Roland
背景：骨质疏松症是一种广泛存在的骨骼疾病，随着年龄的增长而变得更加常见。它的流行情况仍然没有充分的记录。本研究的目的是确定骨质疏松在德国的普遍程度。方法：对德国一家大型法定健康保险承保公司(TK公司)2006-2009年的常规计费数据进行匿名和回顾性分析。50岁及以上患有骨质疏松症的投保人是根据他们被诊断为骨质疏松症或与骨质疏松症相关的骨折，或从他们接受过治疗骨质疏松症的处方药来确定的。结果：2009年德国50岁及以上人群的骨质疏松患病率为14%(170万投保人中有240 657人为骨质疏松)，男性为6%，男性为6%。根据这些数字推断，德国有630万人患有骨质疏松症。根据骨质疏松症的诊断或开出治疗骨质疏松症的药物，同一年龄组的骨质疏松症发病率为每年2.1%，其中104 528人有骨质疏松症的指数事件(首次诊断为骨质疏松症或第一次开出治疗骨质疏松症的药物)。这一数字的外推意味着德国每年有88.5万人新患上骨质疏松症。在观察期间，52%的患者(总计172 473人)持续骨折，其中许多是多发性骨折。结论：骨质疏松在德国仍然很常见。大量的单骨折和多骨折的承保人意味着德国对这种疾病的治疗需要改进。
Background: Osteoporosis is a widespread disease of the skeleton that becomes more common with advancing age. Its prevalence is still inadequately documented. The goal of this study is to determine how common osteoporosis is in Germany.Methods: The routine billing data of a large statutory health insurance carrier in Germany (the TK company) from the years 2006 to 2009 were anonymized and retrospectively analyzed. Insurees aged 50 and above with osteoporosis were identified either from their bearing the diagnosis of osteoporosis or of osteoporosis-related fractures, or from their having received prescription medication for osteoporosis. The prevalence and incidence of osteoporosis and the frequency of osteoporotic fractures were calculated for TK insurees and extrapolated to the overall German population.Results: The prevalence of osteoporosis among persons aged 50 and above, as revealed by diagnoses of osteoporosis or osteoporotic fractures, or by the prescription of medication for osteoporosis, was found to be 14% (240 657 of 1.7 million insurees) in the year 2009; the sex-specific prevalence was 24% in women and 6% in men. An extrapolation of these figures implies that 6.3 million persons in Germany have osteoporosis. The incidence of osteoporosis in the same age group, as revealed by a diagnosis of osteoporosis or prescription of medication for osteoporosis, was found to be 2.1% per year, with 104 528 insurees having an index event for osteoporosis (initial diagnosis of osteoporosis or first prescription of a medication for osteoporosis). An extrapolation of this figure implies that 885 000 persons newly develop osteoporosis in Germany each year. Over the period of observation, 52% of the affected persons (total, 172 473 persons) sustained fractures, many of which were multiple.Conclusion: Osteoporosis is still common in Germany. The large number of insurees with single and multiple fractures implies that the treatment of this disease in Germany needs to be improved.