Fracture prevalence among human immunodeficiency virus (HIV)-infected versus non-HIV-infected patients in a large US healthcare system
Fracture prevalence among human immunodeficiency virus (HIV)-infected versus non-HIV-infected patients in a large US healthcare system
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DOI：
10.1210/jc.2008-0828
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发表时间：
2008-09-01
影响因子：
5.8
通讯作者：
Grinspoon, Steven K.
中科院分区：
文献类型：
--
作者：
Triant, Virginia A.;Brown, Todd T.;Grinspoon, Steven K.
背景：HIV 感染者的骨密度降低，但骨折发生率未知。目的：本研究的目的是比较 HIV 感染者和非 HIV 感染者的骨折发生率。设计：这是一项以人群为基础的研究。背景：该研究在美国大型医疗保健系统中进行。患者：总共 8525 名 HIV 感染者和 2,208,792 名非 HIV 感染者对 1996 年 10 月 1 日至 2008 年 3 月 21 日之间至少发生过一次住院或门诊的患者进行了比较。主要结果测量：使用特定的国际疾病分类第九版临床修订骨折代码测量骨折发生率。结果：与非 HIV 感染者相比，HIV 感染者的整体骨折患病率分别为每 100 人中 2.87 例骨折和 1.77 例骨折。 （P<0.0001）。在女性中，HIV 感染者与非 HIV 感染者的总体骨折发生率分别为每 100 人 2.49 例和 1.72 例（P = 0.002）。与非 HIV 感染女性相比，每 100 人中 HIV 感染女性的椎骨（0.81 vs. 0.45；P = 0.01）和腕部（1.31 vs. 0.83；P = 0.01）骨折发生率较高，但髋部骨折发生率相似（0.47 vs. 0.56；P = 0.53）。在男性中，HIV 感染者与非 HIV 感染者相比，每 100 人中任何骨折（3.08 vs. 1.83；P < 0.0001）、椎骨骨折（1.03 vs. 0.49；P < 0.0001）、髋部骨折（0.79 vs. 0.45；P = 0.001）和腕部骨折的患病率较高骨折（1.46 vs. 0.99；P = 0.001）。非裔美国人、白人女性和白人男性的骨折患病率高于非 HIV 感染者。结论：与非 HIV 感染者相比，HIV 感染者的骨折患病率更高。
Context: Reduced bone mineral density has been demonstrated among HIV-infected patients, but fracture prevalence is unknown.Objective: The objective of the study was to compare fracture prevalence in HIV-infected and non-HIV-infected patients.Design: This was a population-based study.Setting: The study was conducted at a large U. S. health care system.Patients: A total of 8525 HIV-infected and 2,208,792 non-HIV-infected patients with at least one inpatient or outpatient encounter between October 1, 1996, and March 21, 2008, was compared.Main Outcome Measure: Fracture prevalence using specific International Classification of Diseases, Ninth Revision, Clinical Modification fracture codes was measured.Results: The overall fracture prevalence was 2.87 vs. 1.77 patients with fractures per 100 persons in HIV-infected, compared with non-HIV-infected patients (P < 0.0001). Among females, the overall fracture prevalence was 2.49 vs. 1.72 per 100 persons in HIV-infected vs. non-HIV-infected patients (P = 0.002). HIV-infected females had a higher prevalence of vertebral (0.81 vs. 0.45; P = 0.01) and wrist (1.31 vs. 0.83; P = 0.01) fractures per 100 persons, compared with non-HIV-infected females but had a similar prevalence of hip fractures (0.47 vs. 0.56; P = 0.53). Among males, the fracture prevalence per 100 persons was higher in HIV-infected vs. non-HIV-infected patients for any fracture (3.08 vs. 1.83; P < 0.0001), vertebral fractures (1.03 vs. 0.49; P < 0.0001), hip fractures (0.79 vs. 0.45; P = 0.001), and wrist fractures (1.46 vs. 0.99; P = 0.001). Fracture prevalence was higher relative to non-HIV-infected patients among African-American and Caucasian females and Caucasian males.Conclusions: Fracture prevalence is increased in HIV-infected compared with non-HIV-infected patients.