严重精神疾病是 50 岁及以上人群骨质疏松症和脆性骨折记录诊断的风险因素:利用英国初级保健数据进行的回顾性队列研究。

IF 5.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL
British Journal of General Practice Pub Date : 2024-11-28 Print Date: 2024-12-01 DOI:10.3399/BJGP.2024.0055
Christina Avgerinou, Kate Walters, Juan Carlos Bazo-Alvarez, David Osborn, Robert Michael West, Andrew Clegg, Irene Petersen
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引用次数: 0

摘要

背景:严重精神疾病(SMI)与骨密度降低和骨折风险增加有关,但一些研究显示的结果并不一致。目的:在年龄≥50岁的人群中,研究SMI与骨质疏松症(OP)和脆性骨折(FF)诊断记录之间的关联:设计与环境:基于人群的队列研究;英国初级保健:我们使用了匿名初级保健数据(IQVIA 医学研究数据库)。年龄在 50-99 岁(2000-2018 年)、诊断为 SMI 的患者与无 SMI 的患者进行配对。我们使用 Cox 比例危害模型估算危险比 (HR) 和 95% 置信区间 (95%CI)。我们按性别和年龄进行了分层分析,并考虑了社会贫困程度、年份、吸烟、饮酒和体重指数(BMI):共纳入 444 480 人(SMI N=50 006;未暴露 N=394 474)。在男性中,诊断为 SMI 会增加 OP 诊断的可能性,主要在最年轻(50-54 岁:HR=2.12;95%CI 1.61-2.79)和最年长(85-99 岁:HR=2.15;95%CI 1.05-4.37)人群中观察到差异,同时也会增加所有年龄段的 FF 风险。在女性中,SMI仅增加了50-54岁女性诊断OP的风险:HR=1.16;95%CI 1.01-1.34,但增加了所有年龄段女性诊断FF的风险。有 FF 记录的 SMI 男性患者是 OP 诊断患者的两倍多:FF:OP=2.10,而无 SMI 男性的 FF:OP=1.89。患有 SMI 的女性中,FF:OP 的比率为 1.56,而未患有 SMI 的女性中,FF:OP 的比率为 1.11:结论:SMI 与脆性骨折和骨质疏松症诊断不足的可能性增加有关。应考虑采取干预措施,以降低 SMI 患者骨折风险的增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Severe mental illness as a risk factor for recorded diagnosis of osteoporosis and fragility fractures in people aged ≥50 years: retrospective cohort study using UK primary care data.

Background: Severe mental illness (SMI) has been associated with reduced bone density and increased risk of fractures, although some studies have shown inconsistent results.

Aim: To examine the association between SMI and recorded diagnosis of osteoporosis and fragility fracture in people aged ≥50 years.

Design and setting: Population-based cohort study set in UK primary care.

Method: Anonymised primary care data (IQVIA Medical Research Database) were used. Patients with a diagnosis of SMI aged 50-99 years (2000-2018) were matched to individuals without SMI. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Analyses were stratified by sex and age, accounting for social deprivation, year, smoking, alcohol, and body mass index.

Results: In total, 444 480 people were included (SMI n = 50 006; unexposed n = 394 474). In men, diagnosis of SMI increased the likelihood of an osteoporosis diagnosis, with differences mainly observed among the youngest (aged 50-54 years: HR 2.12, 95% CI = 1.61 to 2.79) and the oldest (aged 85-99 years: HR 2.15, 95% CI = 1.05 to 4.37), and SMI increased the risk of fragility fractures across all ages. In women, SMI increased the risk of an osteoporosis diagnosis only in those aged 50-54 years (HR 1.16, 95% CI = 1.01 to 1.34), but increased the risk of fragility fractures across all ages. There were more than twice as many men with SMI with fragility fracture records than with an osteoporosis diagnosis: fragility fracture:osteoporosis = 2.10, compared with fragility fracture:osteoporosis = 1.89 in men without SMI. The fragility fracture:osteoporosis ratio was 1.56 in women with SMI versus 1.11 in women without SMI.

Conclusion: SMI is associated with an increased likelihood of fragility fractures and osteoporosis underdiagnosis. Interventions should be considered to mitigate the increased risk of fractures in people with SMI.

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来源期刊
British Journal of General Practice
British Journal of General Practice 医学-医学:内科
CiteScore
5.10
自引率
10.20%
发文量
681
期刊介绍: The British Journal of General Practice is an international journal publishing research, editorials, debate and analysis, and clinical guidance for family practitioners and primary care researchers worldwide. BJGP began in 1953 as the ‘College of General Practitioners’ Research Newsletter’, with the ‘Journal of the College of General Practitioners’ first appearing in 1960. Following the change in status of the College, the ‘Journal of the Royal College of General Practitioners’ was launched in 1967. Three editors later, in 1990, the title was changed to the ‘British Journal of General Practice’. The journal is commonly referred to as the ''BJGP'', and is an editorially-independent publication of the Royal College of General Practitioners.
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