创作:aluba 审核:aluba 07月20日
  • 纳入18,228名IBD患者及186,871名年龄、性别相匹配的对照,中位随访4.5年;
  • IBD患者的椎骨骨折及髋骨骨折的发生率为2.88/1000人-年,显著高于对照(发生率比值为1.24);
  • 亚组分析显示,克罗恩病(而非溃疡性结肠炎)患者的骨折风险显著升高;
  • IBD患者确诊2年、5年及7年内的椎骨骨折及髋骨骨折累积风险分别为0.6%、1.4%及1.9%,显著高于对照,而皮质类固醇的使用进一步增加了IBD患者的骨折风险(与对照相比的发生率比值为1.37)。
Clinical Gastroenterology and Hepatology上发表的一项回顾性队列研究结果,对近2万名IBD患者及近20万名对照进行多年随访,发现IBD患者(尤其是克罗恩病患者)的椎骨骨折及髋骨骨折风险显著高于对照,且在使用皮质类固醇的患者及确诊年龄>60岁的患者中更为明显。

High risk of fractures within 7 years of diagnosis in Asian patients with inflammatory bowel diseases



06-30, Article

Abstract & Authors:展开

BACKGROUND: /Aims: In this nationwide population-based study, we investigated the risk of vertebral and hip fractures in patients with inflammatory bowel disease (IBD).
METHOD: Using data from the Korean National Health Insurance claims database gathered between 2007 and 2016, we calculated the incidence rate ratios (IRRs) of vertebral and hip fractures in patients with newly diagnosed IBD (n=18,228; 64.1% male, 65.9% ulcerative colitis [UC]) compared with an age- and sex-matched control population (matching ratio, 1:10; n=186,871).
RESULTS: During a median follow-up of 4.5 years, the incidence rate and IRR of vertebral and hip fractures in patients with IBD were 2.88/1,000 person-years and 1.24 (95% CI, 1.08-1.42), respectively. The cumulative risk of vertebral and hip fractures in IBD patients was 0.6%, 1.4%, and 1.9% at 2, 5, and 7 years after diagnosis, respectively, and this risk of fracture in IBD patients was higher than that in matched controls (p=0.002). The use of corticosteroids further increased the risk of fractures in IBD patients (IRR, 1.37; 95% CI 1.13-1.65) compared with matched controls. The risk of fractures was significantly higher in patients with Crohn's disease (CD) (IRR, 1.56; 95% CI, 1.19-2.04) than in matched controls, and this risk remained higher in patients with CD without corticosteroid exposure (IRR, 1.62; 95% CI, 1.12-2.34). The risk of fracture increased with age and was particularly high in females and those with comorbidities.
CONCLUSIONS: The risk of fractures was significantly high in newly diagnosed IBD patients, especially in those with CD regardless of corticosteroid exposure.

First Authors:
Hyung Jin Ahn,Ye-Jee Kim

Correspondence Authors:
Beom-Jun Kim,Sang Hyoung Park

All Authors:
Hyung Jin Ahn,Ye-Jee Kim,Ho Su Lee,Jin Hwa Park,Sung Wook Hwang,Dong-Hoon Yang,Byong Duk Ye,Jeong-Sik Byeon,Seung-Jae Myung,Suk-Kyun Yang,Beom-Jun Kim,Sang Hyoung Park