日本多中心哨点监测系统：股骨头坏死诊断年龄的时间变化及潜在相关因素

Temporal Changes in the Age at Diagnosis of Osteonecrosis of the Femoral Head and Potential Associated Factors: A Multicenter Sentinel Monitoring System in Japan.

作者信息

Tanaka Shinya, Sakai Takashi, Fukushima Wakaba, Takegami Yasuhiko, Ando Wataru, Sugano Nobuhiko, Imagama Shiro

机构信息

Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya-Shi, Japan.

Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan.

出版信息

J Arthroplasty. 2025 Jun 2. doi: 10.1016/j.arth.2025.05.090.

DOI:10.1016/j.arth.2025.05.090

PMID:40466922

Abstract

BACKGROUND

In Japan, a multicenter sentinel monitoring system was implemented as a patient registry for osteonecrosis of the femoral head (ONFH). Although recent monitoring data suggest that the age at diagnosis of ONFH is increasing, it is unclear whether this trend is due to Japan's aging population. We aimed to evaluate the temporal trends in ONFH incidence by age group using other epidemiological data.

METHODS

From the monitoring system up to 2023, patients who had diagnoses between 2002 and 2021 were categorized into four 5-year periods (2002 to 2006, 2007 to 2011, 2012 to 2016, and 2017 to 2021). To determine the incidence by sex and 10-years age groups, the sex- and age-specific proportions of newly diagnosed (incident) ONFH cases were calculated from the monitoring system. Assuming this distribution applies to all ONFH patients in Japan, the numerator of the sex- and age-specific annual incidence rates of ONFH was calculated by multiplying each proportion by the number of incident ONFH patients in the country, as estimated from previous nationwide epidemiological surveys. Japan's sex- and age-specific total population was used as the denominator.

RESULTS

The incidence rate (per 100,000 population) for men aged under 29 years decreased over the four periods (1.08, 1.06, 1.02, and 0.90, respectively), as did the rate for those aged 30 to 39 years (4.40, 3.70, 3.73, and 3.30, respectively). Conversely, an increase was observed in men aged 60 to 69 years (1.69, 1.97, 2.07, and 2.78, respectively). For women, the incidence rate decreased in those under 29 years (1.12, 0.86, 0.78, 0.82), but increased in those aged 50 to 59 years (1.58, 1.23, 2.20, 2.06) and 60 to 69 years (1.28, 1.50, 1.85, 2.03).

CONCLUSIONS

The age at diagnosis of ONFH is increasing among both men and women, even when considering Japan's aging population. The basic characteristics of ONFH may be changing.

摘要

背景

在日本，实施了一个多中心哨点监测系统作为股骨头坏死（ONFH）患者登记系统。尽管近期监测数据表明ONFH的诊断年龄在增加，但尚不清楚这种趋势是否归因于日本人口老龄化。我们旨在利用其他流行病学数据评估按年龄组划分的ONFH发病率的时间趋势。

方法

截至2023年的监测系统中，2002年至2021年期间确诊的患者被分为四个5年时间段（2002年至2006年、2007年至2011年、2012年至2016年以及2017年至2021年）。为确定按性别和10岁年龄组划分的发病率，从监测系统中计算新诊断（发病）ONFH病例的性别和年龄特异性比例。假设这种分布适用于日本所有ONFH患者，根据之前全国性流行病学调查估计的该国ONFH发病患者数量，将每个比例相乘来计算ONFH性别和年龄特异性年发病率的分子。日本的性别和年龄特异性总人口用作分母。

结果

29岁以下男性的发病率（每10万人）在四个时间段内有所下降（分别为1.08、1.06、1.02和0.90），30至39岁男性的发病率也下降（分别为4.40、3.70、3.73和3.30）。相反，60至69岁男性的发病率有所上升（分别为1.69、1.97、2.07和2.78）。对于女性，29岁以下女性的发病率下降（分别为1.12、0.86、0.78、0.82），但50至59岁女性（分别为1.58、1.23、2.20、2.06）和60至69岁女性（分别为1.28、1.50、1.85、2.03）的发病率上升。