Furlano Raoul I, Bloechliger Marlene, Jick Hershel, Meier Christoph R
*Department of Gastroenterology and Nutrition, University Children's Hospital (UKBB), Basel, Switzerland; †Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; ‡Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, MA; and §Hospital Pharmacy, University Hospital Basel, Basel, Switzerland.
J Dev Behav Pediatr. 2014 Jul-Aug;35(6):353-9. doi: 10.1097/DBP.0000000000000070.
Bone fractures in children represent a source of significant disability and morbidity. Are children with autistic spectrum disorder (ASD) at an altered risk of fractures compared with typically developing children?
Using the General Practice Research Database, the authors assessed the prevalence of fractures in boys with ASD diagnosed between 2 and 8 years. A cross-sectional design was used to compare the prevalence of fractures among children with ASD and age-matched controls, conditional logistic regression to explore the relative risk of having a fracture in association with diagnosed ASD.
The study population comprised 3,219 boys with a first-time diagnosis of ASD and 12,265 matched controls. ASD was associated with a significantly decreased risk of developing a fracture at any time in childhood (odds ratio [OR], 0.68, 95% confidence interval [CI], 0.59-0.77, p < .0001). The relative risk estimates were lower for the time period after ASD diagnosis (OR, 0.56, 95% CI, 0.48-0.66, p < .0001) but were not different for the time period before ASD diagnosis (OR, 0.96, 95% CI, 0.78-1.18, p = .6866). Adjusting for use of different drugs did not change the estimates.
The relative risk of experiencing a fracture at any time in childhood is lower for boys with ASD compared with healthy boys.
儿童骨折是导致严重残疾和发病的一个原因。与发育正常的儿童相比，自闭症谱系障碍（ASD）儿童发生骨折的风险是否有所改变？
作者利用全科医学研究数据库评估了2至8岁被诊断为ASD的男孩中骨折的患病率。采用横断面设计比较ASD儿童和年龄匹配的对照组儿童中骨折的患病率，使用条件逻辑回归来探讨与确诊ASD相关的骨折相对风险。
研究人群包括3219名首次诊断为ASD的男孩和12265名匹配的对照组。ASD与儿童期任何时候发生骨折的风险显著降低相关（优势比[OR]为0.68，95%置信区间[CI]为0.59 - 0.77，p < 0.0001）。ASD诊断后的时间段内相对风险估计值较低（OR为0.56，95% CI为0.48 - 0.66，p < 0.0001），但ASD诊断前的时间段内相对风险估计值无差异（OR为0.96，95% CI为0.78 - 1.18，p = 0.6866）。调整不同药物的使用情况并没有改变估计值。
与健康男孩相比，ASD男孩在儿童期任何时候发生骨折的相对风险较低。
