糖皮质激素使用者和非使用者生活方式特征的流行情况：一项丹麦基于人群的横断面研究。

Prevalence of lifestyle characteristics in glucocorticoid users and non-users: a Danish population-based cross-sectional study.

机构信息

Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark

Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.

出版信息

BMJ Open. 2019 Oct 28;9(10):e030780. doi: 10.1136/bmjopen-2019-030780.

DOI:10.1136/bmjopen-2019-030780

PMID:31662378

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6830647/

Abstract

OBJECTIVES

Lifestyle may affect observed associations between glucocorticoid use and adverse events. This study aimed to investigate whether lifestyle differ according to use of systemic glucocorticoids.

DESIGN

Population-based cross-sectional study.

SETTING

The Central Denmark Region.

PARTICIPANTS

30 245 adults (≥25 years of age) who participated in a questionnaire-based public health survey in 2010.

OUTCOME MEASURES

Systemic glucocorticoid use was categorised as never use, current use (prescription redemption ≤90 days before completing the questionnaire), recent use (prescription redemption 91-365 days before completing the questionnaire), former use (prescription redemption >365 days before completing the questionnaire) and according to cumulative dose expressed in prednisolone equivalents (<100, 100-499, 500-999, 1000-1999, 2000-4999, ≥5000 mg). We computed the prevalence of lifestyle factors (body mass index, smoking, alcohol intake, physical activity and dietary habits) according to glucocorticoid use. We then estimated age-adjusted prevalence ratios (aPRs) and 95% CIs, comparing the categories of glucocorticoid users versus never users. All analyses were stratified by sex.

RESULTS

Of the 30 245 participants (53% women, median age 53 years), 563 (1.9%) were current users, 885 (2.9%) were recent users, 3054 (10%) were former users and 25 743 (85%) were never users. Ever users of glucocorticoids had a slightly higher prevalence of obesity than never users (18% vs 14%, aPR=1.4, 95% CI 1.2 to 1.5 in women and 17% vs 15%, aPR=1.2, 95% CI 1.1 to 1.4 in men). In women, ever users of glucocorticoids had a slightly lower prevalence of high-risk alcohol consumption compared with never users (17% vs 20%, aPR=0.8, 95% CI 0.7 to 1.0). Smoking, diet and physical activity did not differ substantially according to use of glucocorticoids.

CONCLUSION

Our study provides a framework for quantifying potential uncontrolled confounding by lifestyle factors in studies of systemic glucocorticoids.

摘要

目的

生活方式可能会影响糖皮质激素使用与不良事件之间的观察到的关联。本研究旨在调查生活方式是否因全身糖皮质激素的使用而不同。

设计

基于人群的横断面研究。

地点

丹麦中部地区。

参与者

30245 名成年人（≥25 岁），他们参加了 2010 年一项基于问卷的公众健康调查。

结局测量

全身糖皮质激素的使用情况分为从未使用、当前使用（处方在完成问卷前 90 天内兑换）、近期使用（处方在完成问卷前 91-365 天内兑换）、过去使用（处方在完成问卷前 365 天以上兑换）和累积剂量（以泼尼松龙当量表示：<100、100-499、500-999、1000-1999、2000-4999、≥5000mg）。根据糖皮质激素的使用情况，我们计算了生活方式因素（体重指数、吸烟、饮酒、体力活动和饮食习惯）的流行率。然后，我们根据糖皮质激素使用者与非使用者的类别，估计了年龄调整后的患病率比（aPR）和 95%置信区间（CI）。所有分析均按性别分层。

结果

在 30245 名参与者中（53%为女性，中位年龄 53 岁），563 名（1.9%）为当前使用者，885 名（2.9%）为近期使用者，3054 名（10%）为过去使用者，25743 名（85%）为从未使用者。与从未使用者相比，糖皮质激素的既往使用者肥胖的患病率略高（女性 18% vs 14%，aPR=1.4，95%CI 1.2-1.5；男性 17% vs 15%，aPR=1.2，95%CI 1.1-1.4）。在女性中，与从未使用者相比，糖皮质激素的既往使用者高危饮酒的患病率略低（17% vs 20%，aPR=0.8，95%CI 0.7-1.0）。吸烟、饮食和体力活动与糖皮质激素的使用没有明显差异。