Increased risk of vertebral fractures and reduced risk of femur fractures in patients with chronic hypoparathyroidism: a nationwide cohort study in Sweden.

IF 5.9 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Sigridur Björnsdottir, Wafa Kamal, Michael Mannstadt, Outi Mäkitie, Tim Spelman, Olle Kämpe, Bente L Langdahl
{"title":"Increased risk of vertebral fractures and reduced risk of femur fractures in patients with chronic hypoparathyroidism: a nationwide cohort study in Sweden.","authors":"Sigridur Björnsdottir, Wafa Kamal, Michael Mannstadt, Outi Mäkitie, Tim Spelman, Olle Kämpe, Bente L Langdahl","doi":"10.1093/jbmr/zjaf061","DOIUrl":null,"url":null,"abstract":"<p><p>Patients with chronic hypoparathyroidism (hypoPT) have reduced bone remodeling, leading to increased bone density and abnormalities in microarchitecture and bone strength. Whether these patients have an increased fracture risk remains unclear. This study aimed to evaluate the risk of major osteoporotic fracture (MOF), osteoporosis diagnoses, and osteoporosis medication use in patients with chronic hypoPT in Sweden. Subtypes of fractures were also assessed. Using the Swedish National Patient Register, the Prescribed Drug Register, and the Total Population Register, we identified 1915 patients with chronic hypoPT treated with active vitamin D between 1997 and 2018, and 15 838 matched controls. After adjustment, patients with chronic hypoPT did not have a higher risk of MOF compared to controls (HR 0.93; 95% CI: 0.69-1.26). However, they had a higher risk of vertebral fractures (HR 1.55; 95% CI: 1.12-2.14) and a lower risk of femur fractures (HR 0.70; 95% CI: 0.50-0.98) compared to controls. They were more often diagnosed with osteoporosis (HR 1.54; 95% CI: 1.21-1.95) but less frequently prescribed osteoporosis medication (HR 0.69; 95% CI: 0.54-0.88) compared to controls. No difference in the MOF risk was observed between females and males (p for interaction = 0.872) or between patients with surgical and non-surgical chronic hypoPT (p for interaction = 0.072). In this large Swedish cohort, chronic hypoPT was not associated with an increased risk of MOF. Vertebral fracture risk was higher, while the femur fracture risk was lower compared to controls. Despite higher prevalence of osteoporosis diagnoses, these patients received less frequently osteoporosis medications.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"860-867"},"PeriodicalIF":5.9000,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188750/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Bone and Mineral Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/jbmr/zjaf061","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0

Abstract

Patients with chronic hypoparathyroidism (hypoPT) have reduced bone remodeling, leading to increased bone density and abnormalities in microarchitecture and bone strength. Whether these patients have an increased fracture risk remains unclear. This study aimed to evaluate the risk of major osteoporotic fracture (MOF), osteoporosis diagnoses, and osteoporosis medication use in patients with chronic hypoPT in Sweden. Subtypes of fractures were also assessed. Using the Swedish National Patient Register, the Prescribed Drug Register, and the Total Population Register, we identified 1915 patients with chronic hypoPT treated with active vitamin D between 1997 and 2018, and 15 838 matched controls. After adjustment, patients with chronic hypoPT did not have a higher risk of MOF compared to controls (HR 0.93; 95% CI: 0.69-1.26). However, they had a higher risk of vertebral fractures (HR 1.55; 95% CI: 1.12-2.14) and a lower risk of femur fractures (HR 0.70; 95% CI: 0.50-0.98) compared to controls. They were more often diagnosed with osteoporosis (HR 1.54; 95% CI: 1.21-1.95) but less frequently prescribed osteoporosis medication (HR 0.69; 95% CI: 0.54-0.88) compared to controls. No difference in the MOF risk was observed between females and males (p for interaction = 0.872) or between patients with surgical and non-surgical chronic hypoPT (p for interaction = 0.072). In this large Swedish cohort, chronic hypoPT was not associated with an increased risk of MOF. Vertebral fracture risk was higher, while the femur fracture risk was lower compared to controls. Despite higher prevalence of osteoporosis diagnoses, these patients received less frequently osteoporosis medications.

Abstract Image

Abstract Image

慢性甲状旁腺功能低下患者椎体骨折风险增加,股骨骨折风险降低:瑞典一项全国队列研究
背景:慢性甲状旁腺功能减退症(hypoPT)患者骨重塑减少,导致骨密度增加,微结构和骨强度异常。这些患者是否有更高的骨折风险尚不清楚。目的:本研究旨在评估瑞典慢性hypoPT患者发生重大骨质疏松性骨折(MOF)的风险、骨质疏松诊断和骨质疏松药物使用情况。对骨折的亚型也进行了评估。方法:使用瑞典国家患者登记册、处方药登记册和总人口登记册,我们确定了1997-2018年期间接受活性维生素D治疗的1915例慢性hypoPT患者,以及15838例匹配对照。结果:调整后,慢性hypoopt患者发生MOF的风险不高于对照组(HR 0.93;95% ci 0.69-1.26)。然而,他们有较高的椎体骨折风险(HR 1.55;95% CI 1.12-2.14),股骨骨折风险较低(HR 0.70;95% CI 0.50-0.98)。他们更常被诊断为骨质疏松症(HR 1.54;95% CI 1.21-1.95),但较少开骨质疏松药物(HR 0.69;95% CI 0.54-0.88)。女性和男性之间(相互作用p = 0.872)或手术和非手术慢性hypoPT患者之间(相互作用p = 0.072) MOF风险无差异。结论:在这个庞大的瑞典队列中,慢性hypoPT与MOF风险增加无关。与对照组相比,椎骨骨折风险较高,而股骨骨折风险较低。尽管骨质疏松症诊断的患病率较高,但这些患者接受骨质疏松症药物治疗的频率较低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Bone and Mineral Research
Journal of Bone and Mineral Research 医学-内分泌学与代谢
CiteScore
11.30
自引率
6.50%
发文量
257
审稿时长
2 months
期刊介绍: The Journal of Bone and Mineral Research (JBMR) publishes highly impactful original manuscripts, reviews, and special articles on basic, translational and clinical investigations relevant to the musculoskeletal system and mineral metabolism. Specifically, the journal is interested in original research on the biology and physiology of skeletal tissues, interdisciplinary research spanning the musculoskeletal and other systems, including but not limited to immunology, hematology, energy metabolism, cancer biology, and neurology, and systems biology topics using large scale “-omics” approaches. The journal welcomes clinical research on the pathophysiology, treatment and prevention of osteoporosis and fractures, as well as sarcopenia, disorders of bone and mineral metabolism, and rare or genetically determined bone diseases.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信