结核病患者发生骨质疏松症和骨质疏松性骨折的风险增加：结核病流行地区的一项基于人群的研究。
Increased risk of incident osteoporosis and osteoporotic fracture in tuberculosis patients: a population-based study in a tuberculosis-endemic area.
作者信息
Chen Y-Y, Feng J-Y, Ting W-Y, Yen Y-F, Chuang P-H, Pan S-W, Su V Y-F, Su W-J
机构信息
Department of Chest Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd., Taipei, 11217, Taiwan.
School of Medicine, National Yang-Ming University, Taipei, Taiwan.
出版信息
Osteoporos Int. 2017 May;28(5):1711-1721. doi: 10.1007/s00198-017-3939-x. Epub 2017 Mar 22.
UNLABELLED
The occurrence of osteoporosis in tuberculosis, a chronic infection, has rarely been evaluated. In this study, we found significantly higher incidence rates of osteoporosis (Adjusted hazard ratio (AHR) 1.82) and osteoporotic fracture (AHR 2.33) in tuberculosis patients than matched cohorts, which suggest that osteoporosis screening should be considered in tuberculosis patients' follow-up program. The aim of this study is to determine the occurrence of incident osteoporosis in patients who completed anti-tuberculosis (TB) treatment.
INTRODUCTION
Chronic inflammatory disorders are associated with an increased risk of osteoporosis. Although TB is an infectious disease characterized by systemic inflammatory responses, the impact of active TB on incident osteoporosis is unclear. We used the Taiwan National Health Insurance Research Database to investigate the association between history of active TB and incident osteoporosis and osteoporotic fracture.
METHODS
In this nationwide retrospective cohort study, active TB patients and their age- and sex-matched controls were identified from the National Health Insurance Research Database in Taiwan during 2000-2012. The occurrence of incident osteoporosis, osteoporotic fractures, and risk factors associated with osteoporosis among TB patients and matched controls were analyzed.
RESULTS
We observed incident osteoporosis in 2.2% (n = 86) of the TB patients and in 1.1% (n = 162) of the matched controls. The incidence rate of osteoporosis was 4.31 and 1.80 per 1000 person-years, which was significantly higher in TB patients (p < 0.001). In multivariate analysis, TB was an independent risk factor for osteoporosis. The other independent factors associated with osteoporosis were older age, female sex, chronic obstructive pulmonary disease, asthma, and lower income. Moreover, we demonstrated that the occurrence of osteoporotic fracture was significantly higher in TB patients.
CONCLUSIONS
Patients with a history of active TB have a higher incidence rate of osteoporosis and osteoporotic fracture.
未标注
骨质疏松症在结核病（一种慢性感染性疾病）中的发生情况鲜有评估。在本研究中，我们发现结核病患者中骨质疏松症（调整后风险比[AHR] 1.82）和骨质疏松性骨折（AHR 2.33）的发病率显著高于匹配队列，这表明在结核病患者的随访计划中应考虑进行骨质疏松症筛查。本研究的目的是确定完成抗结核治疗的患者中偶发性骨质疏松症的发生情况。
引言
慢性炎症性疾病与骨质疏松症风险增加相关。虽然结核病是一种以全身炎症反应为特征的传染病，但活动性结核病对偶发性骨质疏松症的影响尚不清楚。我们利用台湾国民健康保险研究数据库来调查活动性结核病病史与偶发性骨质疏松症及骨质疏松性骨折之间的关联。
方法
在这项全国性回顾性队列研究中，从2000年至2012年台湾国民健康保险研究数据库中识别出活动性结核病患者及其年龄和性别匹配的对照。分析了结核病患者和匹配对照中偶发性骨质疏松症、骨质疏松性骨折的发生情况以及与骨质疏松症相关的危险因素。
结果
我们观察到2.（此处原英文有误，推测是2.2%）%（n = 86）的结核病患者发生了偶发性骨质疏松症，而匹配对照中这一比例为1.1%（n = 162）。骨质疏松症的发病率分别为每1000人年4.31例和1.80例，结核病患者的发病率显著更高（p < 0.001）。在多变量分析中，结核病是骨质疏松症的独立危险因素。与骨质疏松症相关的其他独立因素包括年龄较大、女性、慢性阻塞性肺疾病、哮喘和收入较低。此外，我们证明结核病患者中骨质疏松性骨折的发生率显著更高。
结论
有活动性结核病病史的患者骨质疏松症和骨质疏松性骨折的发病率更高。
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