HIV 感染及其与临床骨折风险增加的关联：一项全国范围内的病例对照研究。
HIV infection and its association with an excess risk of clinical fractures: a nationwide case-control study.
机构信息
*Oxford National Institute for Health Research (NIHR), Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; †Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; ‡Internal Medicine Department, Musculoskeletal Research Unit and Red Tematica de Investigacion Cooperativa en Envejecimiento y Fragilidad (RETICEF), Fundacio Institut Mar d'Investigacions Mediques (FIMIM), and Instituto de Salud Carlos III, Barcelona, Spain; §Institut d'Investigacio en Atencio Primaria (IDIAP), Jordi Gol-Primary Care Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain; ‖Department of Internal Medicine and Infectious Diseases, Parc Salut Mar, Barcelona, Spain; ¶Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands; #Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center, Maastricht, The Netherlands; **Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands; ††Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands; and ‡‡Aalborg Hospital, Aalborg University, Aalborg, Denmark.
出版信息
J Acquir Immune Defic Syndr. 2014 May 1;66(1):90-5. doi: 10.1097/QAI.0000000000000112.
BACKGROUND
Different studies have reported an association between HIV infection, antiretroviral therapies, and impaired bone metabolism, but data on their impact on fracture risk are scarce. We studied the association between a clinical diagnosis of HIV infection and fracture risk.
METHODS
We conducted a case-control study using data from the Danish National Health Service registries, including 124,655 fracture cases and 373,962 age- and gender-matched controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression.
RESULTS
A total of 50 (0.40/1000) patients in the fracture group and 52 (0.14/1000) controls had an HIV diagnosis. The risk of any fracture was thus significantly increased among HIV-infected patients (age- and gender-matched OR = 2.89, 95% CI: 1.99 to 4.18). Similarly, significant increases in the risk of hip (OR = 8.99, 95% CI: 1.39 to 58.0), forearm (OR = 3.50, 95% CI: 1.26 to 9.72), and spine fractures (OR = 9.00, 95% CI: 1.39 to 58.1) were observed.
CONCLUSIONS
HIV infection is associated with an almost 3-fold increase in fracture risk compared with that of age- and gender-matched uninfected patients. HIV patients are also at an almost 9-fold higher risk of hip fracture.
背景
不同的研究报告称 HIV 感染、抗逆转录病毒疗法与骨代谢受损之间存在关联，但关于它们对骨折风险影响的数据却很少。我们研究了 HIV 感染的临床诊断与骨折风险之间的关联。
方法
我们使用丹麦国家卫生服务登记处的数据开展了一项病例对照研究，共纳入 124655 例骨折病例和 373962 名年龄和性别匹配的对照者。采用条件 logistic 回归估计比值比（OR）及其 95%置信区间（CI）。
结果
骨折组中共有 50 例（0.40/1000）患者和对照组中有 52 例（0.14/1000）患者被诊断为 HIV 感染。与未感染 HIV 的患者相比，HIV 感染者发生任何骨折的风险均显著增加（年龄和性别匹配 OR=2.89，95%CI：1.99 至 4.18）。同样，髋部（OR=8.99，95%CI：1.39 至 58.0）、前臂（OR=3.50，95%CI：1.26 至 9.72）和脊柱骨折（OR=9.00，95%CI：1.39 至 58.1）的风险也显著增加。
结论
与年龄和性别匹配的未感染患者相比，HIV 感染患者的骨折风险增加近 3 倍。HIV 患者髋部骨折的风险也增加近 9 倍。
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