Hip fractures in patients with primary aldosteronism - a Swedish nationwide study.

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Osteoporosis International Pub Date : 2024-09-01 Epub Date: 2024-06-05 DOI:10.1007/s00198-024-07132-2

Eleftheria Gkaniatsa, Tatiana Zverkova Sandström, Annika Rosengren, Penelope Trimpou, Andreas Muth, Gudmundur Johannsson, Oskar Ragnarsson

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引用次数: 0

Abstract

In this large population-based matched cohort study, patients with primary aldosteronism were at increased risk of hip fracture, particularly subgroups traditionally considered at higher risk of osteoporosis such as women, patients older than 56 years at diagnosis, patients with established cardiovascular disease at diagnosis, and patients treated with MRA.

Purpose: Previous studies suggest that primary aldosteronism (PA) is associated with dysregulated bone homeostasis. The aim of this study was to evaluate the incidence of hip fractures in patients with PA.

Methods: We studied a nationwide cohort of 2419 patients with PA (1997-2019) and 24 187 age and sex matched controls from the general population. Hip fractures were identified by ICD codes in the Swedish National Patient Register. We estimated hazard ratios (HRs) for incident hip fractures, adjusted for prior fractures, socioeconomic factors, diabetes, osteoporosis, hyperparathyroidism, and cardiovascular disease (CVD). Pairwise subgroup comparisons were performed by age (18-56 and > 56 years), sex, CVD at baseline, and treatment for PA.

Results: During a mean follow up of 8 ± 5 years, 64 (2.6%) patients had a hip fracture after being diagnosed with PA, compared to 401 (1.7%) controls. After adjustments, PA was associated with a 55% increased risk of hip fracture compared to controls (HR 1.55 [1.18-2.03]). HRs were increased in women (HR 1.76 [95% CI 1.24-2.52]), patients aged > 56 years (HR 1.62 [95% CI 1.21-2.17]), and patients with CVD at diagnosis (HR 2.15 [95% CI 1.37-3.37]). PA patients treated with adrenalectomy did not have higher risk than controls (HR 0.84 [95% CI 0.35-2.0]), while patients treated with mineralocorticoid receptor antagonists (MRA) retained a greater risk (HR 1.84 [95% CI 1.20-2.83]).

Conclusion: PA is associated with increased hip fracture risk, especially in women, patients diagnosed after the age of 56 years and patients with established CVD at diagnosis. Also, patients treated with MRA seem to have an increased risk of hip fractures, while adrenalectomy may be protective.

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查看原文本刊更多论文

原发性醛固酮增多症患者的髋部骨折--一项瑞典全国性研究。

在这项基于人群的大型匹配队列研究中，原发性醛固酮增多症患者发生髋部骨折的风险增加，尤其是传统上被认为骨质疏松症风险较高的亚组，如女性、确诊时年龄超过 56 岁的患者、确诊时已患有心血管疾病的患者以及接受 MRA 治疗的患者。本研究旨在评估 PA 患者髋部骨折的发生率：我们对全国范围内的 2419 名 PA 患者（1997-2019 年）和 24 187 名年龄和性别匹配的普通人群对照组进行了研究。髋部骨折是通过瑞典全国患者登记册中的 ICD 编码确定的。我们估算了发生髋部骨折的危险比（HRs），并对既往骨折、社会经济因素、糖尿病、骨质疏松症、甲状旁腺功能亢进和心血管疾病（CVD）进行了调整。按年龄（18-56 岁和大于 56 岁）、性别、基线时的心血管疾病和 PA 治疗情况进行了配对亚组比较：在平均 8 ± 5 年的随访期间，64 例（2.6%）患者在确诊 PA 后发生髋部骨折，而对照组为 401 例（1.7%）。经调整后，与对照组相比，PA 导致髋部骨折的风险增加了 55%（HR 1.55 [1.18-2.03]）。女性（HR 1.76 [95% CI 1.24-2.52]）、年龄大于 56 岁的患者（HR 1.62 [95% CI 1.21-2.17]）和诊断时患有心血管疾病的患者（HR 2.15 [95% CI 1.37-3.37]）的 HR 值均有所增加。接受肾上腺切除术治疗的PA患者的风险并不比对照组高（HR 0.84 [95% CI 0.35-2.0]），而接受矿物质皮质激素受体拮抗剂（MRA）治疗的患者的风险更高（HR 1.84 [95% CI 1.20-2.83]）：结论：PA 与髋部骨折风险增加有关，尤其是女性、56 岁以后确诊的患者以及确诊时已患有心血管疾病的患者。此外，接受 MRA 治疗的患者发生髋部骨折的风险似乎会增加，而肾上腺切除术可能具有保护作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Osteoporosis International 医学-内分泌学与代谢

CiteScore

8.10

自引率

10.00%

发文量

224

审稿时长

3 months

期刊介绍： An international multi-disciplinary journal which is a joint initiative between the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA, Osteoporosis International provides a forum for the communication and exchange of current ideas concerning the diagnosis, prevention, treatment and management of osteoporosis and other metabolic bone diseases. It publishes: original papers - reporting progress and results in all areas of osteoporosis and its related fields; review articles - reflecting the present state of knowledge in special areas of summarizing limited themes in which discussion has led to clearly defined conclusions; educational articles - giving information on the progress of a topic of particular interest; case reports - of uncommon or interesting presentations of the condition. While focusing on clinical research, the Journal will also accept submissions on more basic aspects of research, where they are considered by the editors to be relevant to the human disease spectrum.