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中风和骨质疏松症:一项台湾队列研究。

Stroke and osteoporosis: a Taiwan cohort study.

机构信息

Department of Neurosurgery, The Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, Jiangsu, P.R. China.

Department of Neurosurgery, The No.7 People's Hospital of Hebei Province, Dingzhou, Hebei, P.R. China.

出版信息

Postgrad Med J. 2021 Apr;97(1146):211-216. doi: 10.1136/postgradmedj-2019-136959. Epub 2020 Mar 12.

Abstract

BACKGROUND

Osteoporosis and stroke are major health problems that have potentially overlapping pathophysiological mechanisms. The aim of this study was to estimate osteoporosis risk in Taiwan patientswho had a stroke.

METHOD

This study retrieved data contained in the Taiwan National Health Insurance Research Database for a population-based sample of consecutive patients either hospitalised for stroke or treated for stroke on an outpatient basis. A total of 7550 newly diagnosed patientswho had a stroke were enrolled during 1996-2010. Osteoporosis risk in these patients was then compared with a matched group of patients who had not had a stroke randomly selected from the database at a ratio of 1:4 (n=30 200). The relationship between stroke history and osteoporosis risk was estimated with Cox proportional hazard regression models.

RESULTS

During the follow-up period, osteoporosis developed in 1537 patients who had a stroke and in 5830 patients who had not had a stroke. The incidence of osteoporosis for cohorts with and without stroke was 32.97 and 14.28 per 1000 person-years, respectively. After controlling for covariates, the overall risk of osteoporosis was 1.82-fold higher in the stroke group than in the non-stroke group. The relative osteoporosis risk contributed by stroke had apparently greater impact among male gender and younger age groups.

CONCLUSION

History of stroke is a risk factor for osteoporosis in Taiwan. Much attention to stroke-targeted treatment modalities might minimise adverse outcomes of osteoporosis.

摘要

背景

骨质疏松症和中风是两个主要的健康问题,它们具有潜在的重叠病理生理学机制。本研究旨在评估台湾中风患者的骨质疏松症风险。

方法

本研究从台湾全民健康保险研究数据库中提取了连续住院或门诊治疗中风患者的数据。1996 年至 2010 年期间共纳入了 7550 例新诊断为中风的患者。然后,将这些患者的骨质疏松症风险与数据库中按 1:4 比例随机选择的未发生中风的患者进行比较(n=30200)。使用 Cox 比例风险回归模型评估中风病史与骨质疏松症风险之间的关系。

结果

在随访期间,1537 例中风患者和 5830 例未发生中风的患者发生了骨质疏松症。有和无中风的队列中骨质疏松症的发生率分别为 32.97 和 14.28/1000 人年。在调整了混杂因素后,中风组的整体骨质疏松症风险是无中风组的 1.82 倍。中风对骨质疏松症的相对风险在男性和年龄较小的患者中影响更大。

结论

中风病史是台湾骨质疏松症的一个危险因素。对中风靶向治疗方法的重视可能会最小化骨质疏松症的不良后果。

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