BACKGROUND Slipped capital femoral epiphysis (SCFE) is a disorder of the proximal femoral physis occurring in late childhood and adolescence. Previously postulated risk factors include obesity and endocrinopathies. The purpose of this investigation was to identify risk factors for developing SCFE, as well as postslip osteonecrosis (ON), among the United States pediatric population. METHODS A national database investigation was performed using PearlDiver Technologies, Inc., queried for SCFE and ON using International Classification of Disease codes (2010 to 2020). Regression analyses to determine the risk of developing a SCFE, and ON after a patient has already been diagnosed with a SCFE ("postslip"). Propensity matching between SCFE and control groups generated a pseudo-randomization model to compare the relative risk. RESULTS There were 11,465 patients with SCFE available in the database, matched with 134,680 controls. After matching, vitamin D deficiency, obesity, hypothyroidism, and growth hormone use were risk factors for developing SCFE [relative risk ranges from 1.42 (95% CI: 1.21-1.39, vitamin D deficiency) to 3.45 (95% CI: 3.33-3.57, obesity)]. ON risk factors were vitamin D deficiency [1.65 (1.26-2.14)] and hypothyroidism [1.49 (1.10-2.07)]. CONCLUSIONS This United States national database study quantified risk factors of developing an SCFE and postslip ON. Obesity is the most significant risk factor for the development of a slip, but not ON. Growth hormone use, hypothyroidism, and vitamin D deficiency are also risk factors for SCFE development, whereas only the latter two were associated with ON. These findings demonstrate the public health implications of obesity and comorbid conditions in pediatric hip pathology. LEVEL OF EVIDENCE Level III.

中文翻译：

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量化股骨头骨骺滑脱和滑脱后骨坏死的风险因素。

背景技术股骨头骨骺滑脱（SCFE）是一种发生于儿童晚期和青春期的近端股骨骨骺疾病。先前假设的危险因素包括肥胖和内分泌疾病。本次调查的目的是确定美国儿科人群发生 SCFE 以及滑脱后骨坏死 (ON) 的危险因素。方法 使用 PearlDiver Technologies, Inc. 进行国家数据库调查，使用国际疾病分类代码（2010 年至 2020 年）查询 SCFE 和 ON。回归分析以确定患者发生 SCFE 的风险，以及在患者已被诊断患有 SCFE（“后滑”）后发生 ON 的风险。SCFE 和对照组之间的倾向匹配生成了一个伪随机模型来比较相对风险。结果 数据库中有 11,465 名 SCFE 患者，与 134,680 名对照者相匹配。匹配后，维生素 D 缺乏、肥胖、甲状腺功能减退和生长激素使用是发生 SCFE 的危险因素[相对风险范围为 1.42（95% CI：1.21-1.39，维生素 D 缺乏）至 3.45（95% CI：3.33-3.57） ，肥胖）]。ON 的危险因素是维生素 D 缺乏 [1.65 (1.26-2.14)] 和甲状腺功能减退症 [1.49 (1.10-2.07)]。结论 这项美国国家数据库研究量化了发生 SCFE 和后滑 ON 的风险因素。肥胖是发生滑倒的最重要风险因素，但不是 ON。生长激素的使用、甲状腺功能减退和维生素 D 缺乏也是 SCFE 发展的危险因素，而只有后两者与 ON 相关。这些发现证明了肥胖和儿科髋关节病理学共存疾病对公共健康的影响。证据级别 III 级。