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美国成人注意力缺陷多动障碍药物与骨密度

Attention deficit hyperactivity disorder medications and bone mineral density of adults in the United States.

作者信息

Lawson Michael Jeremy, Beltran Thomas A, Padilla Carla R, Berry-Cabán Cristóbal S, Choi Y Sammy

机构信息

Department of Family Medicine, Womack Army Medical Center, 2817 Reilly Road, Fort Bragg, NC 28310, USA.

Department of Research, Womack Army Medical Center, 2817 Reilly Road, Fort Bragg, NC 28310, USA.

出版信息

Bone Rep. 2022 Apr 20;16:101570. doi: 10.1016/j.bonr.2022.101570. eCollection 2022 Jun.

Abstract

INTRODUCTION

Several medications used to treat attention deficit hyperactivity disorder (ADHD) have been associated with diminished bone mineral density (BMD) in children. The objective of this study was to determine if evidence exists for a similar association among adults.

MATERIALS AND METHODS

A retrospective cross-sectional analysis was conducted using data collected by the National Health Nutrition Examination Survey 2013-2018. Data from 7961 individuals aged 18 to 50, 79 of whom were taking medications to treat ADHD. Dual-energy X-ray absorptiometry scans provided measure of body composition. Linear regression models were used to examine associations between ADHD medication use and body composition.

RESULTS

Stimulant ADHD medication usage was found to be associated with decreased BMD in both the skull (-6.6%; 95% CI 5.9-7.2) ( < 0.05) and thoracic spine (-6.0%; 95% CI 5.1-7.0) ( < 0.05). No difference in BMD was seen in any other skeletal region based on stimulant ADHD medication use ( > 0.05). We found no evidence to suggest that duration of use affected the observed decreases in BMD,  > 0.05.

CONCLUSION

This study using a nationally representative sample assessed whether stimulant medication use in adults with ADHD was associated with decreased BMD. The overall results are inconclusive. Further study is needed to better evaluate if ADHD and/or stimulant medication use is independently associated with bone health.

摘要

引言

几种用于治疗注意力缺陷多动障碍(ADHD)的药物与儿童骨矿物质密度(BMD)降低有关。本研究的目的是确定成人中是否也存在类似关联的证据。

材料与方法

使用2013 - 2018年国家健康与营养检查调查收集的数据进行回顾性横断面分析。数据来自7961名年龄在18至50岁的个体,其中79人正在服用治疗ADHD的药物。双能X线吸收法扫描提供身体成分测量。线性回归模型用于检验ADHD药物使用与身体成分之间的关联。

结果

发现使用治疗ADHD的兴奋剂药物与颅骨BMD降低(-6.6%;95%可信区间5.9 - 7.2)(<0.05)和胸椎BMD降低(-6.0%;95%可信区间5.1 - 7.0)(<0.05)相关。基于使用治疗ADHD的兴奋剂药物,在任何其他骨骼区域未观察到BMD差异(>0.05)。我们没有发现证据表明使用持续时间会影响观察到的BMD降低,>0.05。

结论

本研究使用具有全国代表性的样本评估了患有ADHD的成年人使用兴奋剂药物是否与BMD降低有关。总体结果尚无定论。需要进一步研究以更好地评估ADHD和/或兴奋剂药物使用是否与骨骼健康独立相关。

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