Acromegaly and the long-term fracture risk of the vertebra and hip: a national cohort study

被引：6

作者：

Kwon, Hyemi ^{[1
]}

Han, Kyung-Do ^{[2
]}

Kim, Bong-Sung ^{[2
]}

Moon, Sun Joon ^{[1
]}

Park, Se Eun ^{[1
]}

Rhee, Eun-Jung ^{[1
]}

Lee, Won-Young ^{[1
]}

机构：

[1] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Dept Internal Med, Div Endocrinol & Metab,Sch Med, 29 Saemunan Ro, Seoul 03181, South Korea

[2] Soongsil Univ, Dept Stat & Actuarial Sci, Seoul, South Korea

来源：

OSTEOPOROSIS INTERNATIONAL | 2023年 / 34卷 / 09期

关键词：

Acromegaly; Fractures; bone; Growth hormone-secreting pituitary adenoma; Hip fractures; Osteoporosis; Spinal fractures; BONE-MINERAL DENSITY; DISEASE-ACTIVITY; TRABECULAR BONE; PREVALENCE; TURNOVER; ASSOCIATION;

D O I：

10.1007/s00198-023-06800-z

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

In this national cohort study, the patients with acromegaly had significantly higher risks of clinical vertebral (HR 2.09 [1.58-2.78]) and hip (HR 2.52 [1.61-3.95]) fractures than the controls. The increased fracture risk in patients with acromegaly was time-dependent and was observed even during the early period of follow-up.PurposeAcromegaly is characterized by the overproduction of growth hormone (GH) and insulin-like growth factor-1 (IGF-1), both play important roles in regulating bone metabolism. We investigated the risk of vertebral and hip fractures in patients with acromegaly compared to age- and sex-matched controls.MethodsThis nationwide population-based cohort study included 1,777 patients with acromegaly aged 40 years or older in 2006-2016 and 8,885 age- and sex-matched controls. A Cox proportional hazards model was used to estimate the adjusted hazard ratio (HR) [95% confidence interval].ResultsThe mean age was 54.3 years and 58.9% were female. For approximately 8.5 years of follow-up, the patients with acromegaly had significantly higher risks of clinical vertebral (HR 2.09 [1.58-2.78]) and hip (HR 2.52 [1.61-3.95]) fractures than the controls in the multivariate analyses. There were significant differences in the risks of clinical vertebral (P < 0.0001) and hip (P < 0.0001) fractures between the patients with acromegaly and the controls in the Kaplan-Meier survival analysis. The multivariable-adjusted HRs for clinical vertebral fractures comparing the patients with acromegaly with controls during and excluding the first 7 years of observation were 1.69 [1.15-2.49] and 2.70 [1.75-4.17], respectively. The HRs for hip fractures during and excluding the first 7 years of observation were 2.29 [1.25-4.18] and 3.36 [1.63-6.92], respectively.ConclusionsThe patients with acromegaly had a higher risk of hip fractures as well as clinical vertebral fractures than the controls. The increased fracture risk in patients with acromegaly was time-dependent and was observed even during the early period of follow-up.

引用

页码：1591 / 1600

页数：10

共 38 条

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