People with x-linked hypophosphataemic rickets (XLH) are at increased risk of depression, according to a study published in Rheumatology.
The study describes additional comorbidities in XLH patients compared with general population controls.
The Clinical Practice Research Datalink (CPRD) GOLD was used to identify a cohort of XLH patients (1995-2016), along with a non-XLH cohort matched (1:4) on age, sex and GP practice.
Median age at first recorded code pertaining to XLH was 12.5 years with an overall median follow-up of 10.2 years. There were 41,976 eligible recorded event/diagnosis codes during study follow-up among the 320 individuals included in analyses, with the median number per patient being 119 and 80 for XLH and non-XLH patients, respectively.
For primary analyses, 273 individual conditions were merged into 15 major disease categories. Using the CALIBER portal, phenotyping algorithms were used to identify the first diagnosis (and associated age) of 273 comorbid conditions during patient follow-up. Fifteen major disease categories were used, and the proportion of patients having one or more diagnosis was compared between cohorts for each category and condition. Main analyses were repeated according to Index of Multiple Deprivation (IMD).
The analysis included 64 and 256 patients in the XLH and non-XLH cohorts, respectively. There was an increased prevalence of endocrine (OR, 3.46; 95% CI, 1.44-8.31) and neurological (OR, 3.01; 95% CI, 1.41-6.44) disorders among XLH patients.
Across all specific comorbidities, four were at least twice as likely to be present in XLH cases, but this was only significant for depression (OR, 2.95; 95% CI, 1.47-5.92). Distribution of IMD among XLH cases indicated greater deprivation than the general population.
The authors concluded that there is a higher risk of mental illness in XLH patients compared with matched controls, and greater than expected deprivation.
They say the findings may have implications for clinical practice guidelines and decisions around health and social care provision for these patients.
