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NHANES 横断面研究阿司匹林与老年人骨折。

NHANES cross sectional study of aspirin and fractures in the elderly.

机构信息

Faculty of Medicine, Aleppo University, Aleppo, 22743, Syria.

Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

出版信息

Sci Rep. 2023 Feb 1;13(1):1879. doi: 10.1038/s41598-023-29029-6.

Abstract

Bone fractures are a global public health concern, yet no thorough investigation of low-dose aspirin usage to prevent fractures in the elderly has been conducted. Many interventional human and animal studies have tried to detect the correct role of low-dose aspirin on fractures in elderly persons. The literature doesn't consist of a retrospective observational study that includes a large number of older individuals and evaluates the accurate effect of aspirin on the fractures post falling from low heights. This cross-sectional includes 7132 elderly persons and aimed to detect if there was a link between taking low-dose aspirin to prevent fractures in the elderly. Data was extracted from the National Health and Nutrition Examination Survey (NHANES) database for 2017-2020 and 2013-2014. Demographic and examination data were collected during in-home interviews and study visits to a mobile examination center. Standardized questionnaires were used to collect information such as age, gender, race, educational level, and family income-to-poverty ratio. Body mass index (BMI), weight, standing height, upper leg length, upper arm length, arm circumference, and wrist circumference were all measured during the examination. The study examined 8127 patients, with 7132 elderly patients suitable for data analysis. The odds ratio of fractures due to a fall from standing height or less was 0.963 (95 percent confidence interval 0.08-1.149) in low-dose aspirin users, while having parents with osteoporosis had a related risk of 1.23. (95 percent confidence interval 0.81-1.8). The total number of fractures was 1295; with hip fractures constituting up to 13.82%, wrist fractures of 66.56%, and spine fractures of 19.61%. There was no significant difference in femur and spine bone mineral density (BMD) in the two groups (use low dose aspirin and don't use). Females had a 5.6 times greater fracture risk related to a fall from standing height or less (1 time or more) than males (P-value < 0.001). Furthermore, taking aspirin had no effect on the occurrence of fractures from standing height or less in older people (P-value = 0.468). In addition, the logistic regression after performing the propensity matching score confirmed that there was no impact of taking aspirin on the occurrence of fractures (P-value > 0.05). This cross-sectional study reveals that taking low-dose aspirin to prevent fractures in the elderly is statistically insignificant. However, fractures are more common in older persons, especially in older women; thus, more widespread injury prevention initiatives and access to osteoporosis prevention and diagnosis for older people should improve to minimize the overall burden.

摘要

骨折是一个全球性的公共卫生问题,但目前还没有对老年人使用低剂量阿司匹林预防骨折进行全面的研究。许多干预性的人体和动物研究试图检测低剂量阿司匹林对老年人骨折的确切作用。文献中没有一项包括大量老年人的回顾性观察研究,也没有评估低剂量阿司匹林对从低高度坠落导致的骨折的准确影响。本横断面研究纳入了 7132 名老年人,旨在检测老年人服用低剂量阿司匹林预防骨折是否存在关联。数据来自 2017-2020 年和 2013-2014 年的国家健康与营养调查(NHANES)数据库。在家庭访谈和移动体检中心的研究访问期间收集了人口统计学和检查数据。使用标准化问卷收集了年龄、性别、种族、教育水平和家庭收入与贫困比率等信息。在检查过程中测量了体重指数(BMI)、体重、站立身高、大腿长度、手臂长度、臂围和手腕围。该研究共纳入了 8127 名患者,其中 7132 名老年患者适合进行数据分析。与父母双方均患有骨质疏松症相比,低剂量阿司匹林使用者因从站立高度或更低高度跌倒而导致骨折的比值比(OR)为 0.963(95%置信区间 0.08-1.149),而因从站立高度或更低高度跌倒而导致骨折的比值比(OR)为 1.23(95%置信区间 0.81-1.8)。总的骨折数量为 1295 例;其中髋部骨折占 13.82%,腕部骨折占 66.56%,脊柱骨折占 19.61%。两组(使用低剂量阿司匹林和不使用)的股骨和脊柱骨密度(BMD)无显著差异。女性因从站立高度或更低高度跌倒而导致骨折的风险是男性的 5.6 倍(P 值<0.001)。此外,在老年人中,服用阿司匹林并不能降低从站立高度或更低高度跌倒引起的骨折发生率(P 值=0.468)。此外,在进行倾向评分匹配评分后进行的逻辑回归证实,服用阿司匹林对骨折的发生没有影响(P 值>0.05)。本横断面研究表明,在老年人中使用低剂量阿司匹林预防骨折在统计学上是无意义的。然而,骨折在老年人中更为常见,尤其是老年女性;因此,应该加强更广泛的伤害预防措施,并为老年人提供骨质疏松症的预防和诊断,以最大限度地降低整体负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7663/9892582/5c9145ed4157/41598_2023_29029_Fig1_HTML.jpg

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