Risk of fracture in patients with muscular dystrophies
Risk of fracture in patients with muscular dystrophies
Summary: the aim of the study was to determine fracture risk in incident muscular dystrophy (MD) patients. Patients with MD are at a 1.4-fold increased risk of fracture as compared with population-based control patients. Risk further increased among elderly and female patients and among patients exposed to oral glucocorticoids.
Introduction: muscular dystrophies (MDs) are inherited diseases causing muscle weakness and thereby increase the risk of falling and detrimental effects on bone. Both are recognised risk factors for fracture. Therefore, the aim of this study was to determine the hazard ratio of fracture in patients with MD.
Methods: we conducted a retrospective cohort study using the UK General Practice Research Database (1987–2012). Each patient with MD was matched by year of birth, sex and practice to up to six patients without a history of MD. Outcome measure was all fractures.
Results: as compared with control patients, risk of any fracture was statistically significantly increased in MD patients (adjusted hazard ratio [AHR], 1.40; 95 % confidence interval [CI], 1.14–1.71). An increased risk of fracture was observed among MD patients with female gender (AHR, 1.78; 95 % CI, 1.33–2.40) and an increasing age as compared with control patients. Stratification to Duchenne MD showed no association with fracture, whereas risk of fracture was increased twofold among patients with myotonic dystrophy (AHR, 2.34; 95 % CI, 1.56–3.51). MD patients had an almost tripled risk of fracture when they used oral glucocorticoids in the previous 6 months as compared to non-users with MD.
Conclusion: patients with MD are at a 1.4-fold increased risk of fracture as compared with population-based control patients. Especially in older age groups and female gender, the fracture risk of MD versus non-MD patients is increased, whereas exposure to glucocorticoids further increased fracture risk among MD patients.
509-518
Pouwels, S.
3d97460d-5b2e-4ec6-b46f-e82e338cf0c1
de Boer, A.
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Leufkens, H.G.M.
04854167-bea6-4508-a8e2-aeb920a2d6b1
Weber, W.E.J.
dbad85f0-566e-477e-8c37-816ffb1f300a
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
van Onzenoort, H.A.W.
47093271-14ae-4291-a022-7bd44360a923
de Vries, Frank
10245a32-6083-4feb-9d20-7e7db0f358b1
February 2014
Pouwels, S.
3d97460d-5b2e-4ec6-b46f-e82e338cf0c1
de Boer, A.
5621b588-a1e0-4827-8940-89efef278f13
Leufkens, H.G.M.
04854167-bea6-4508-a8e2-aeb920a2d6b1
Weber, W.E.J.
dbad85f0-566e-477e-8c37-816ffb1f300a
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
van Onzenoort, H.A.W.
47093271-14ae-4291-a022-7bd44360a923
de Vries, Frank
10245a32-6083-4feb-9d20-7e7db0f358b1
Pouwels, S., de Boer, A., Leufkens, H.G.M., Weber, W.E.J., Cooper, C., van Onzenoort, H.A.W. and de Vries, Frank
(2014)
Risk of fracture in patients with muscular dystrophies.
Osteoporosis International, 25 (2), .
(doi:10.1007/s00198-013-2442-2).
(PMID:23948807)
Abstract
Summary: the aim of the study was to determine fracture risk in incident muscular dystrophy (MD) patients. Patients with MD are at a 1.4-fold increased risk of fracture as compared with population-based control patients. Risk further increased among elderly and female patients and among patients exposed to oral glucocorticoids.
Introduction: muscular dystrophies (MDs) are inherited diseases causing muscle weakness and thereby increase the risk of falling and detrimental effects on bone. Both are recognised risk factors for fracture. Therefore, the aim of this study was to determine the hazard ratio of fracture in patients with MD.
Methods: we conducted a retrospective cohort study using the UK General Practice Research Database (1987–2012). Each patient with MD was matched by year of birth, sex and practice to up to six patients without a history of MD. Outcome measure was all fractures.
Results: as compared with control patients, risk of any fracture was statistically significantly increased in MD patients (adjusted hazard ratio [AHR], 1.40; 95 % confidence interval [CI], 1.14–1.71). An increased risk of fracture was observed among MD patients with female gender (AHR, 1.78; 95 % CI, 1.33–2.40) and an increasing age as compared with control patients. Stratification to Duchenne MD showed no association with fracture, whereas risk of fracture was increased twofold among patients with myotonic dystrophy (AHR, 2.34; 95 % CI, 1.56–3.51). MD patients had an almost tripled risk of fracture when they used oral glucocorticoids in the previous 6 months as compared to non-users with MD.
Conclusion: patients with MD are at a 1.4-fold increased risk of fracture as compared with population-based control patients. Especially in older age groups and female gender, the fracture risk of MD versus non-MD patients is increased, whereas exposure to glucocorticoids further increased fracture risk among MD patients.
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Published date: February 2014
Organisations:
Faculty of Medicine
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Local EPrints ID: 363182
URI: http://eprints.soton.ac.uk/id/eprint/363182
ISSN: 0937-941X
PURE UUID: 85698e08-4f97-45dc-868d-f0a02817f81b
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Date deposited: 24 Mar 2014 08:44
Last modified: 18 Mar 2024 02:45
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Author:
S. Pouwels
Author:
A. de Boer
Author:
H.G.M. Leufkens
Author:
W.E.J. Weber
Author:
H.A.W. van Onzenoort
Author:
Frank de Vries
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