重症肌无力患者骨质疏松风险增加：一项基于人群的队列研究。
Increased risk of osteoporosis in patients with myasthenia gravis: a population-based cohort study.
机构信息
From the Department of Neurology (J.-H.Y., H.-C.C.) and Department of Nuclear Medicine and PET Center (Y.-K.C.), Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Management Office for Health Data (H.-J.C.), Graduate Institute of Clinical Medical Science and School of Medicine (C.-H.K.), College of Medicine (H.-J.C.), and Department of Nuclear Medicine and PET Center (C.-H. K.), China Medical University Hospital, Taichung, Taiwan; and School of Medicine (J.-H.Y., H.-C.C., Y.-K.C.), Fu Jen Catholic University, New Taipei City, Taiwan.
出版信息
Neurology. 2014 Sep 16;83(12):1075-9. doi: 10.1212/WNL.0000000000000804. Epub 2014 Aug 13.
OBJECTIVE
To determine the risk of osteoporosis in patients with myasthenia gravis (MG) in a large cohort representing 99% of the population of Taiwan.
METHODS
Data from the Taiwan National Health Insurance Research Database were used to conduct retrospective cohort analyses. The study cohort consisted of 2,073 patients with MG who were 3-fold frequency-matched by age and sex and assigned the same index year as a comparison cohort without MG. Cox proportional hazard regression analysis was conducted to estimate the risk of osteoporosis.
RESULTS
The MG cohort had a 1.96-fold increased risk of developing osteoporosis compared with the comparison cohort (hazard ratio [HR] = 1.96, 95% confidence interval [CI] = 1.57-2.44). Patients with MG older than 30 years developed an increased risk of osteoporosis, with the highest risk in the age group from 30 to 44 years, compared with the control cohort. Corticosteroid-naïve patients with MG had a 1.52-fold increased risk of developing osteoporosis (HR = 1.52, 95% CI = 1.11-2.08), and the corticosteroid-treated cohort had a 2.37-fold increased risk of developing osteoporosis (HR = 2.37, 95% CI = 1.82-3.07).
CONCLUSION
This population-based retrospective cohort study provides evidence that MG is associated with a high risk of osteoporosis regardless of corticosteroid use.
目的
在一个代表台湾 99%人口的大型队列中，确定重症肌无力（MG）患者骨质疏松的风险。
方法
使用来自台湾全民健康保险研究数据库的数据进行回顾性队列分析。研究队列包括 2073 名 MG 患者，这些患者的年龄和性别与对照组进行了 3 倍频数匹配，并与对照组分配了相同的指数年。采用 Cox 比例风险回归分析来估计骨质疏松的风险。
结果
MG 队列发生骨质疏松的风险是对照组的 1.96 倍（风险比[HR] = 1.96，95%置信区间[CI] = 1.57-2.44）。年龄大于 30 岁的 MG 患者发生骨质疏松的风险增加，与对照组相比，30 至 44 岁年龄组的风险最高。未使用皮质类固醇的 MG 患者发生骨质疏松的风险增加 1.52 倍（HR = 1.52，95%CI = 1.11-2.08），而接受皮质类固醇治疗的队列发生骨质疏松的风险增加 2.37 倍（HR = 2.37，95%CI = 1.82-3.07）。
结论
这项基于人群的回顾性队列研究提供了证据，表明 MG 与骨质疏松的高风险相关，无论是否使用皮质类固醇。
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