Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia.
Barwon Health, University Hospital, Geelong, Australia.
J Musculoskelet Neuronal Interact. 2021 Sep 1;21(3):422-428.
We aimed to investigate fracture risk associated with anticonvulsant use in a population-based sample of men and women.
Data from 1,458 participants (51.8% women) with a radiologically confirmed incident fracture (cases) were compared to 1,796 participants (46.5% women) without fracture (controls). Lifestyle factors, medication use and medical history were self-reported. Associations between anticonvulsant use and fracture were explored using binary logistic regression following adjustment for confounders.
In men, fracture cases and controls differed in age, smoking history, education, alcohol use, and gonadal hormone supplementation. In women, fracture cases and controls differed by previous fracture history, alcohol use, physical activity levels and use of anti-fracture agents. After adjustment for age, pooled anticonvulsant use was associated with a 3.4-fold higher risk of fracture in men and a 1.8-fold higher risk in women. Following further adjustments for confounders these patterns persisted; a 2.8-fold higher fracture risk in men and a 1.8-fold higher fracture risk in women.
Anticonvulsant use was associated with increased fracture risk, independent of demographic, lifestyle, medical and medication related factors. While further studies exploring potential underlying mechanisms are warranted, regular monitoring of bone health in anticonvulsant users with risk factors may be useful.
我们旨在调查基于人群的男性和女性样本中抗癫痫药物使用与骨折风险的相关性。
数据来自 1458 名（51.8%为女性）经影像学证实的骨折患者（病例）和 1796 名（46.5%为女性）无骨折患者（对照）。生活方式因素、药物使用和病史均由患者自行报告。在调整混杂因素后，使用二元逻辑回归探索抗癫痫药物使用与骨折之间的关系。
在男性中，骨折病例和对照组在年龄、吸烟史、教育程度、饮酒和性腺激素补充方面存在差异。在女性中，骨折病例和对照组在既往骨折史、饮酒、体力活动水平和使用抗骨折药物方面存在差异。调整年龄后，汇总的抗癫痫药物使用与男性骨折风险增加 3.4 倍和女性骨折风险增加 1.8 倍相关。进一步调整混杂因素后，这些模式仍然存在；男性骨折风险增加 2.8 倍，女性骨折风险增加 1.8 倍。
抗癫痫药物的使用与骨折风险增加相关，独立于人口统计学、生活方式、医学和药物相关因素。虽然需要进一步研究探索潜在的机制，但对抗癫痫药物使用者的骨骼健康进行常规监测，尤其是有风险因素的患者，可能会有所帮助。
