Sigridur Björnsdottir, Wafa Kamal, Michael Mannstadt, Outi Mäkitie, Tim Spelman, Olle Kämpe, Bente L Langdahl
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引用次数: 0
摘要
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。
Increased risk of vertebral fractures and reduced risk of femur fractures in patients with chronic hypoparathyroidism: a nationwide cohort study in Sweden.
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.
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.