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De Metz C, Hennart B, Aymes E, Cren P, Martignène N, Penel N, Barthoulot M, Carnot A. Complete DPYD genotyping combined with dihydropyrimidine dehydrogenase phenotyping to prevent fluoropyrimidine toxicity: A retrospective study. Cancer Med 2024; 13:e7066. [PMID: 38523525 PMCID: PMC10961597 DOI: 10.1002/cam4.7066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 01/19/2024] [Accepted: 02/18/2024] [Indexed: 03/26/2024] Open
Abstract
INTRODUCTION In April 2019, French authorities mandated dihydropyrimidine dehydrogenase (DPD) screening, specifically testing uracilemia, to mitigate the risk of toxicity associated with fluoropyrimidine-based chemotherapy. However, this subject is still of debate as there is no consensus on a standardized DPD deficiency screening test. We conducted a real-life retrospective study with the aim of assessing the impact of DPD screening on the occurrence of severe toxicity and exploring the potential benefits of complete genotyping using next-generation sequencing. METHODS All adult patients consecutively treated with 5-fluorouracil (5-FU) or its oral prodrug at six cancer centers between March 2018 and February 2019 were considered for inclusion. Dihydropyrimidine dehydrogenase deficiency screening included gene encoding DPD (DPYD) genotyping using complete genome sequencing and DPD phenotyping (uracilemia or dihydrouracilemia/uracilemia ratio) or both tests. Associations between each DPD screening method and (i) severe (grade ≥3) early toxicity and (ii) fluoropyrimidine dose reduction in the second chemotherapy cycle were evaluated using multivariable logistic regression analysis. Furthermore, we assessed the concordance between DPD genotype and phenotype using Cohen's kappa. RESULTS A total of 551 patients were included. Most patients were tested for DPD deficiency (86%) including DPYD genotyping only (6%), DPD phenotyping only (8%), or both (72%). Complete DPD deficiency was not detected in the study population. Severe early toxicity events were observed in 73 patients (13%), with two patients (0.30%) presenting grade 5 toxicity. Despite the numerically higher toxicity rate in untested patients, the occurrence of severe toxicity was not significantly associated with the DPD screening method (p = 0.69). Concordance between the DPD genotype and phenotype was weak (Cohen's kappa of 0.14). CONCLUSION Due to insufficient numbers, our study was not able to demonstrate any added value of DPYD genotyping using complete genome sequencing to prevent 5-FU toxicity. The optimal strategy for DPD screening before fluoropyrimidine-based chemotherapy requires further clinical evaluation.
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Affiliation(s)
- Côme De Metz
- Department of Medical OncologyCentre Oscar LambretLilleFrance
| | - Benjamin Hennart
- Toxicology Unit, Biology and Pathology CentreLille University Medical CentreLilleFrance
| | - Estelle Aymes
- Department of BiostatisticsCentre Oscar LambretLilleFrance
| | - Pierre‐Yves Cren
- Department of Medical OncologyCentre Oscar LambretLilleFrance
- Department of BiostatisticsCentre Oscar LambretLilleFrance
| | | | - Nicolas Penel
- Department of Medical OncologyCentre Oscar LambretLilleFrance
- Univ. Lille, CHU Lille, ULR 2694 ‐ Metrics: Evaluation des technologies de santé et des pratiques médicalesLilleFrance
| | | | - Aurélien Carnot
- Department of Medical OncologyCentre Oscar LambretLilleFrance
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Fovet T, Scouflaire T, Belet B, Demeulemeester E, Paindavoine M, Gibour C, Claeyman V, Ghislain L, Narguet C, El Qaoubii O, Martignène N, Wathelet M, Védère M, Moncany AH, Bouchard JP. Soins psychiatriques et sortie de prison : des équipes mobiles transitionnelles pour atténuer le « choc post-carcéral » ? Annales Médico-psychologiques, revue psychiatrique 2023. [DOI: 10.1016/j.amp.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Quindroit P, Fruchart M, Degoul S, Perichon R, Martignène N, Soula J, Marcilly R, Lamer A. Definition of a Practical Taxonomy for Referencing Data Quality Problems in Health Care Databases. Methods Inf Med 2023; 62:19-30. [PMID: 36356592 DOI: 10.1055/a-1976-2371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Health care information systems can generate and/or record huge volumes of data, some of which may be reused for research, clinical trials, or teaching. However, these databases can be affected by data quality problems; hence, an important step in the data reuse process consists in detecting and rectifying these issues. With a view to facilitating the assessment of data quality, we developed a taxonomy of data quality problems in operational databases. MATERIAL We searched the literature for publications that mentioned "data quality problems," "data quality taxonomy," "data quality assessment," or "dirty data." The publications were then reviewed, compared, summarized, and structured using a bottom-up approach, to provide an operational taxonomy of data quality problems. The latter were illustrated with fictional examples (though based on reality) from clinical databases. RESULTS Twelve publications were selected, and 286 instances of data quality problems were identified and were classified according to six distinct levels of granularity. We used the classification defined by Oliveira et al to structure our taxonomy. The extracted items were grouped into 53 data quality problems. DISCUSSION This taxonomy facilitated the systematic assessment of data quality in databases by presenting the data's quality according to their granularity. The definition of this taxonomy is the first step in the data cleaning process. The subsequent steps include the definition of associated quality assessment methods and data cleaning methods. CONCLUSION Our new taxonomy enabled the classification and illustration of 53 data quality problems found in hospital databases.
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Affiliation(s)
- Paul Quindroit
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
| | - Mathilde Fruchart
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
| | - Samuel Degoul
- Department of Anesthesiology and Intensive Care Unit, Groupe Hospitalier de la Région de Mulhouse et Sud-Alsace, Mulhouse, France
| | - Renaud Perichon
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
| | - Niels Martignène
- F2RSM Psy - Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France, Saint-André-Lez-Lille, France.,InterHop, Lille, France
| | - Julien Soula
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
| | - Romaric Marcilly
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
| | - Antoine Lamer
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille, France.,F2RSM Psy - Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France, Saint-André-Lez-Lille, France.,InterHop, Lille, France
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Wathelet M, Horn M, Creupelandt C, Fovet T, Baubet T, Habran E, Martignène N, Vaiva G, D’Hondt F. Mental Health Symptoms of University Students 15 Months After the Onset of the COVID-19 Pandemic in France. JAMA Netw Open 2022; 5:e2249342. [PMID: 36580328 PMCID: PMC9857035 DOI: 10.1001/jamanetworkopen.2022.49342] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
IMPORTANCE The Conséquences de la pandémie de COVID-19 sur la santé mentale des étudiants (COSAMe) survey was conducted among university students in France during the COVID-19 pandemic and found that although there was a slight decrease in anxiety, depression, and stress between the first lockdown (T1) and 1 month after it ended (T2), the prevalence of suicidal ideation had increased between these periods and 1 in 5 students had probable posttraumatic stress disorder (PTSD) at T2. These results emphasize the need to explore the long-term consequences of the COVID-19 pandemic. OBJECTIVES To measure the prevalence of mental health symptoms among university students in France 15 months after the first lockdown (T3) and to identify factors associated with outcomes. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study reports data from the third measurement time of the repeated COSAMe survey, which took place from July 21 to August 31, 2021, through an online questionnaire sent to all French university students. MAIN OUTCOMES AND MEASURES The prevalence of suicidal thoughts, PTSD (PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition] [PCL-5]), stress (Perceived Stress Scale), anxiety (State-Trait Anxiety Inventory), and depression (Beck Depression Inventory) at T3 were gender- and degree-standardized and compared with prevalence rates at T1 and T2. Multivariable logistic regression analyses identified risk factors. RESULTS A total of 44 898 students completed the questionnaires. They were mainly women (31 728 [70.7%]), and the median (IQR) age was 19 (18-21) years. Standardized prevalence rates of stress, anxiety, depression, suicidal thoughts, and PTSD were 20.6% (95% CI, 20.2%-21.0%), 23.7% (95% CI, 23.3%-24.1%), 15.4% (95% CI, 15.1%-15.8%), 13.8% (95% CI, 13.5%-14.2%), and 29.8% (95% CI, 29.4%-30.2%), respectively. Compared with the decreased prevalence rates at T2, there was an increase at T3 for stress (2.5% increase), anxiety (13.9% increase), and depression (22.2% increase). The prevalence of suicidal ideation continued to increase from T1 (10.6%) to T3 (13.8%), and the prevalence of probable PTSD increased from 1 in 5 students to 1 in 3 students between T2 and T3. Female and nonbinary participants; participants without children and living in an urban area; and those with financial difficulties, a chronic condition, psychiatric history, COVID-19 history, social isolation, and low perceived quality of information received were at risk of all poor outcomes at T3 (eg, stress among women: adjusted OR, 2.18; 95% CI, 2.05-2.31; suicidal thoughts among nonbinary respondents: adjusted OR, 5.09; 95% CI, 4.32-5.99; anxiety among students with children: adjusted OR, 0.68; 95% CI, 0.56-0.81; depression among students living in a rural area: adjusted OR, 0.80; 95% CI, 0.75-0.85). CONCLUSIONS AND RELEVANCE These results suggest severe long-lasting consequences associated with the pandemic on the mental health of students. Prevention and care access should be a priority.
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Affiliation(s)
- Marielle Wathelet
- Department of Psychiatry, Centre Hospitalo-Universitaire de Lille, Lille, France
- Fédération de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France, Lille, France
- Centre National de Ressources et de Résilience Lille-Paris, Lille, France
- University Lille, Inserm, Centre Hospitalo-Universitaire de Lille, U1172–Lille Neuroscience & Cognition, Lille, France
| | - Mathilde Horn
- Department of Psychiatry, Centre Hospitalo-Universitaire de Lille, Lille, France
- University Lille, Inserm, Centre Hospitalo-Universitaire de Lille, U1172–Lille Neuroscience & Cognition, Lille, France
| | | | - Thomas Fovet
- Department of Psychiatry, Centre Hospitalo-Universitaire de Lille, Lille, France
- University Lille, Inserm, Centre Hospitalo-Universitaire de Lille, U1172–Lille Neuroscience & Cognition, Lille, France
| | - Thierry Baubet
- Centre National de Ressources et de Résilience Lille-Paris, Lille, France
- Assistance Publique–Hôpitaux de Paris, Avicenne Hospital, Department of Infant, Child and Adolescent Psychiatry, Sorbonne Paris Nord University, Centre de recherche en Epidémiologie et Santé des Populations, Bobigny, France
| | - Enguerrand Habran
- Fonds Fédération Hospitalière de France Recherche et Innovation, Paris, France
| | - Niels Martignène
- Fédération de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France, Lille, France
- Centre National de Ressources et de Résilience Lille-Paris, Lille, France
| | - Guillaume Vaiva
- Department of Psychiatry, Centre Hospitalo-Universitaire de Lille, Lille, France
- Centre National de Ressources et de Résilience Lille-Paris, Lille, France
- University Lille, Inserm, Centre Hospitalo-Universitaire de Lille, U1172–Lille Neuroscience & Cognition, Lille, France
| | - Fabien D’Hondt
- Department of Psychiatry, Centre Hospitalo-Universitaire de Lille, Lille, France
- Centre National de Ressources et de Résilience Lille-Paris, Lille, France
- University Lille, Inserm, Centre Hospitalo-Universitaire de Lille, U1172–Lille Neuroscience & Cognition, Lille, France
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Wathelet M, Vincent C, Fovet T, Notredame CE, Habran E, Martignène N, Baubet T, Vaiva G, D'Hondt F. Evolution in French University Students' Mental Health One Month After the First COVID-19 Related Quarantine: Results From the COSAMe Survey. Front Psychiatry 2022; 13:868369. [PMID: 35592379 PMCID: PMC9110762 DOI: 10.3389/fpsyt.2022.868369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/12/2022] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION The COVID-19 related quarantine had negative psychological effects among University students. Evidence from previous epidemics suggests that negative psychological effects of quarantine measures can last or even worsen after the quarantine lift. The objective of this study was to assess the evolution of students' mental health and to identify factors associated with mental health outcomes 1 month after the lift of the lockdown. MATERIALS AND METHODS This repeated cross-sectional study collected data during the first quarantine in France (T1, N = 68,891) and 1 month after its lift (T2, N = 22,540), through an online questionnaire sent to all French University students. Using cross-sectional data, we estimated prevalence rates of suicidal thoughts, severe anxiety (State-Trait Anxiety Inventory, State subscale), depression (Beck Depression Inventory), and stress (Perceived Stress Scale) at T1 and T2. Using longitudinal data (N = 6,346), we identified risk factors of poor mental health outcomes among sociodemographic characteristics, precariousness indicators, health-related data, information on the social environment, and media consumption, adjusting for baseline mental health status. RESULTS We found lower prevalence rates of severe stress (21.7%), anxiety (22.1%), and depression (13·9%) one month after the quarantine compared to the quarantine period (24.8%, 27.5%, and 16.1%, respectively). The prevalence rate of suicidal thoughts increased from 11.4 to 13.2%. Regardless of the existence of symptoms during quarantine, four factors were systematically associated with poor mental health outcomes 1 month after the quarantine was lifted: female gender, a low feeling of integration before the quarantine period, a low quality of social ties during the quarantine, and a history of psychiatric follow-up. CONCLUSIONS The prevalence rates of severe stress, anxiety, and depression, although being lower than during the first lockdown, remained high after its lift. The prevalence rate of suicidal ideation increased. This stresses the need to consider the enduring psychological impact of the pandemic on students as a critical public health issue.
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Affiliation(s)
- Marielle Wathelet
- Univ. Lille, INSERM, Lille University Hospital (CHU de Lille), U1172-LilNCog - Lille Neuroscience & Cognition, Lille, France.,Fédération de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France (F2RSM), Lille, France.,Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France.,Department of Psychiatry, Lille University Hospital (CHU de Lille), Lille, France
| | - Camille Vincent
- Department of Public Health, Lille University Hospital (CHU de Lille), Lille, France
| | - Thomas Fovet
- Univ. Lille, INSERM, Lille University Hospital (CHU de Lille), U1172-LilNCog - Lille Neuroscience & Cognition, Lille, France.,Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France.,Department of Psychiatry, Lille University Hospital (CHU de Lille), Lille, France
| | - Charles-Edouard Notredame
- Univ. Lille, INSERM, Lille University Hospital (CHU de Lille), U1172-LilNCog - Lille Neuroscience & Cognition, Lille, France.,Department of Psychiatry, Lille University Hospital (CHU de Lille), Lille, France
| | | | - Niels Martignène
- Fédération de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France (F2RSM), Lille, France.,Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France
| | - Thierry Baubet
- Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France.,Department of Infant, AP-HP, Avicenne Hospital, Child and Adolescent Psychiatry, Sorbonne Paris Nord, Paris, France
| | - Guillaume Vaiva
- Univ. Lille, INSERM, Lille University Hospital (CHU de Lille), U1172-LilNCog - Lille Neuroscience & Cognition, Lille, France.,Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France.,Department of Psychiatry, Lille University Hospital (CHU de Lille), Lille, France
| | - Fabien D'Hondt
- Univ. Lille, INSERM, Lille University Hospital (CHU de Lille), U1172-LilNCog - Lille Neuroscience & Cognition, Lille, France.,Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France.,Department of Psychiatry, Lille University Hospital (CHU de Lille), Lille, France
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Leroy A, Wathelet M, Fovet T, Habran E, Granon B, Martignène N, Amad A, Notredame CE, Vaiva G, D'Hondt F. Mental health among medical, healthcare, and other university students during the first COVID-19 lockdown in France. J Affect Disord Rep 2021; 6:100260. [PMID: 34746911 PMCID: PMC8557945 DOI: 10.1016/j.jadr.2021.100260] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 10/19/2021] [Accepted: 10/19/2021] [Indexed: 11/18/2022] Open
Abstract
Background The COVID-19 pandemic has raised concerns regarding its psychological effect on university students, especially healthcare students. We aimed at assessing the risk of mental health problems according to the type of university studies, by adjusting for potential confounders. Methods We used data from the COSAMe study, a national cross-sectional survey including 69,054 French university students during the first quarantine. The mental health outcomes evaluated were suicidal thoughts, severe self-reported distress (as assessed by the Impact of Events Scale–Revised), stress (Perceived Stress Scale), anxiety (State-Trait Anxiety Inventory, State subscale), and depression (Beck Depression Inventory). Multivariable logistic regression analyzes were performed to test the association between the type of university studies (healthcare studies: medical and non-medical, and non-healthcare studies) and poor mental health outcomes, adjusted for sociodemographic characteristics, precariousness indicators, health-related data, quality of social relationships, and data about media consumption. Results Compared to non-healthcare students (N = 59,404), non-medical healthcare (N = 5,431) and medical students (N = 4,193) showed a lower risk of presenting at least one poor mental health outcome (adjusted OR [95%CI] = 0.86[0.81–0.92] and 0.87[0.81–0.93], respectively). Compared to non-healthcare students, medical students were at lower risk of suicidal thoughts (0.83[0.74–0.93]), severe self-reported distress (0.75[0.69–0.82]) and depression (0.83[0.75–0.92]). Non-medical healthcare students were at lower risk of severe selfreported distress (0.79[0.73–0.85]), stress (0.92[0.85–0.98]), depression (0.83[0.76–0.91]), and anxiety (0.86[0.80–0.92]). Limitations This is a large but not representative cross-sectional study, limited to the first confinement. Conclusions Being a healthcare student is a protective factor for mental health problems among confined students. Mediating factors still need to be explored.
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Affiliation(s)
- Arnaud Leroy
- Department of Psychiatry, CHU Lille, Lille F-59000, France
- Inserm, CHU Lille, U1172, LilNCog, Lille Neuroscience & Cognition, University of Lille, Lille F-59000, France
- Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille F-59000, France
| | - Marielle Wathelet
- Department of Psychiatry, CHU Lille, Lille F-59000, France
- Inserm, CHU Lille, U1172, LilNCog, Lille Neuroscience & Cognition, University of Lille, Lille F-59000, France
- Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille F-59000, France
- Fédération de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France, Lille F-59000, France
| | - Thomas Fovet
- Department of Psychiatry, CHU Lille, Lille F-59000, France
- Inserm, CHU Lille, U1172, LilNCog, Lille Neuroscience & Cognition, University of Lille, Lille F-59000, France
- Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille F-59000, France
| | - Enguerrand Habran
- Fonds Fédération Hospitalière de France Recherche et Innovation, Paris, France
| | - Benoît Granon
- Department of Psychiatry, CHU Lille, Lille F-59000, France
| | - Niels Martignène
- Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille F-59000, France
- Fédération de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France, Lille F-59000, France
| | - Ali Amad
- Department of Psychiatry, CHU Lille, Lille F-59000, France
- Inserm, CHU Lille, U1172, LilNCog, Lille Neuroscience & Cognition, University of Lille, Lille F-59000, France
- Fédération de Recherche en Psychiatrie et Santé Mentale des Hauts-de-France, Lille F-59000, France
| | - Charles-Edouard Notredame
- Department of Psychiatry, CHU Lille, Lille F-59000, France
- Inserm, CHU Lille, U1172, LilNCog, Lille Neuroscience & Cognition, University of Lille, Lille F-59000, France
| | - Guillaume Vaiva
- Department of Psychiatry, CHU Lille, Lille F-59000, France
- Inserm, CHU Lille, U1172, LilNCog, Lille Neuroscience & Cognition, University of Lille, Lille F-59000, France
- Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille F-59000, France
| | - Fabien D'Hondt
- Department of Psychiatry, CHU Lille, Lille F-59000, France
- Inserm, CHU Lille, U1172, LilNCog, Lille Neuroscience & Cognition, University of Lille, Lille F-59000, France
- Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille F-59000, France
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Paccou J, Martignène N, Lespessailles E, Babykina E, Pattou F, Cortet B, Ficheur G. Gastric Bypass But Not Sleeve Gastrectomy Increases Risk of Major Osteoporotic Fracture: French Population-Based Cohort Study. J Bone Miner Res 2020; 35:1415-1423. [PMID: 32187759 DOI: 10.1002/jbmr.4012] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 02/14/2020] [Accepted: 03/10/2020] [Indexed: 12/29/2022]
Abstract
The objective of this work was to investigate the risk of major osteoporotic fracture (MOF; hip, proximal humerus, wrist and distal forearm, and clinical spine) in bariatric surgery patients versus matched controls. Bariatric surgery is associated with an increase in fracture risk. However, it remains unclear whether the same degree of fracture risk is associated with sleeve gastrectomy, which has recently surpassed gastric bypass. Records from the French National Inpatient database were used from 2008 to 2018. Bariatric surgery patients, aged 40 to 65 years, with BMI ≥40 kg/m2 , hospitalized between January 1, 2010 and December 31, 2014, were matched to one control (1:1) by age, sex, Charlson comorbidity index, year of inclusion, and class of obesity (40 to 49.9 kg/m2 versus ≥50 kg/m2 ). We performed a Cox regression analysis to assess the association between the risk of any MOF and, respectively, (i) bariatric surgery (yes/no) and (ii) type of surgical procedure (gastric bypass, gastric banding, vertical banded gastroplasty, and sleeve gastrectomy) versus no surgery. A total of 81,984 patients were included in the study (40,992 in the bariatric surgery group, and 40,992 matched controls). There were 585 MOFs in the surgical group (2.30 cases per 1000 patient-year [PY]) and 416 MOFs in the matched controls (1.93 cases per 1000 PY). The risk of MOF was significantly higher in the surgical group (hazard ratio [HR] 1.22; 95% CI, 1.08-1.39). We observed an increase in risk of MOF for gastric bypass only (HR 1.70; 95% CI, 1.46-1.98) compared with the matched controls. In patients aged 40 to 65 years, gastric bypass but not sleeve gastrectomy or the other procedures increased risk of major osteoporotic fractures. © 2020 American Society for Bone and Mineral Research.
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Affiliation(s)
- Julien Paccou
- Department of Rheumatology, University of Lille, University Hospital Center (CHU) of Lille, Marrow Adiposity and Bone Interactions (MABLab) (ULR 4490), Lille, France
| | - Niels Martignène
- Department of Public Health, University of Lille, University Hospital Center (CHU) of Lille, Epidemiology and Quality of Care (EA2694), Lille, France
| | - Eric Lespessailles
- Department of Rheumatology, University of Orléans, Regional Hospital Center (CHR) of Orléans, Multiscale Multimodal Imaging and Modeling of Bone and Joint Tissue (I3MTO) Laboratory (EA4708), Orléans, France
| | - Evgéniya Babykina
- Department of Public Health, University of Lille, University Hospital Center (CHU) of Lille, Epidemiology and Quality of Care (EA2694), Lille, France
| | - François Pattou
- INSERM, Endocrine and Metabolic Surgery, University of Lille, University Hospital Center (Lille University Hospital), Laboratory for Translational Research on Diabetes (UMR 1190), Lille, France
| | - Bernard Cortet
- Department of Rheumatology, University of Lille, University Hospital Center (CHU) of Lille, Marrow Adiposity and Bone Interactions (MABLab) (ULR 4490), Lille, France
| | - Grégoire Ficheur
- Department of Public Health, University of Lille, University Hospital Center (CHU) of Lille, Epidemiology and Quality of Care (EA2694), Lille, France
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