Risk of fragility fracture among patients with sarcoidosis: a population-based study 1976–2013

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Abstract

Summary: Incidence of fragility fracture of a population-based cohort of 345 patients with sarcoidosis was compared with age and sex-matched comparators. The incidence of fragility fracture was higher among patients with sarcoidosis with hazard ratio (HR) of 2.18. Introduction: Several chronic inflammatory disorders increase the risk of fragility fracture. However, little is known about the risk of fragility fracture in patients with sarcoidosis. Methods: This study was conducted using a previously identified population-based cohort of 345 patients with incident sarcoidosis from Olmsted County, Minnesota. Diagnosis of sarcoidosis required physician diagnosis supported by biopsy showing non-caseating granuloma, radiographic evidence of intrathoracic sarcoidosis, and compatible clinical presentations without evidence of other granulomatous diseases. Sex and age-matched subjects randomly selected from the same underlying population were used as comparators. Medical records of cases and comparators were reviewed for baseline characteristics and incident fragility fracture. Results: Fragility fractures were observed in 34 patients with sarcoidosis, corresponding to a cumulative incidence of 5.6% at 10 years, while 18 fragility fractures were observed among comparators for a cumulative incidence of 2.4% at 10 years. The HR of fragility fractures among cases compared with comparators was 2.18 (95% confidence interval [CI], 1.23–3.88). The risk of fragility fracture by site was significantly higher among patients with sarcoidosis, and was due to a higher rate of distal forearm fracture (HR 3.58; 95% CI 1.53–8.40). Statistically non-significant increased risk was also observed in proximal femur (HR 1.66; 95% CI 0.45–6.06) and proximal humerus (HR 3.27; 95% CI 0.66–16.21). Risk of vertebral fracture was not increased (HR 1.00; 95% CI 0.32–3.11). Conclusion: Patients with sarcoidosis have an increased risk of fragility fracture which is primarily driven by the higher incidence of distal forearm fracture.

Original languageEnglish (US)
Pages (from-to)1-5
Number of pages5
JournalOsteoporosis International
DOIs
StateAccepted/In press - Feb 16 2017

Fingerprint

Sarcoidosis
Population
Confidence Intervals
Incidence
Forearm
Humerus
Granuloma
Femur
Medical Records
Physicians
Biopsy

Keywords

  • Epidemiology
  • Fragility fracture
  • Glucocorticoids
  • Sarcoidosis

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

@article{02d6c7c47ca6418cb7871d6684e4deeb,
title = "Risk of fragility fracture among patients with sarcoidosis: a population-based study 1976–2013",
abstract = "Summary: Incidence of fragility fracture of a population-based cohort of 345 patients with sarcoidosis was compared with age and sex-matched comparators. The incidence of fragility fracture was higher among patients with sarcoidosis with hazard ratio (HR) of 2.18. Introduction: Several chronic inflammatory disorders increase the risk of fragility fracture. However, little is known about the risk of fragility fracture in patients with sarcoidosis. Methods: This study was conducted using a previously identified population-based cohort of 345 patients with incident sarcoidosis from Olmsted County, Minnesota. Diagnosis of sarcoidosis required physician diagnosis supported by biopsy showing non-caseating granuloma, radiographic evidence of intrathoracic sarcoidosis, and compatible clinical presentations without evidence of other granulomatous diseases. Sex and age-matched subjects randomly selected from the same underlying population were used as comparators. Medical records of cases and comparators were reviewed for baseline characteristics and incident fragility fracture. Results: Fragility fractures were observed in 34 patients with sarcoidosis, corresponding to a cumulative incidence of 5.6{\%} at 10 years, while 18 fragility fractures were observed among comparators for a cumulative incidence of 2.4{\%} at 10 years. The HR of fragility fractures among cases compared with comparators was 2.18 (95{\%} confidence interval [CI], 1.23–3.88). The risk of fragility fracture by site was significantly higher among patients with sarcoidosis, and was due to a higher rate of distal forearm fracture (HR 3.58; 95{\%} CI 1.53–8.40). Statistically non-significant increased risk was also observed in proximal femur (HR 1.66; 95{\%} CI 0.45–6.06) and proximal humerus (HR 3.27; 95{\%} CI 0.66–16.21). Risk of vertebral fracture was not increased (HR 1.00; 95{\%} CI 0.32–3.11). Conclusion: Patients with sarcoidosis have an increased risk of fragility fracture which is primarily driven by the higher incidence of distal forearm fracture.",
keywords = "Epidemiology, Fragility fracture, Glucocorticoids, Sarcoidosis",
author = "P. Ungprasert and Cynthia Crowson and Matteson, {Eric Lawrence}",
year = "2017",
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doi = "10.1007/s00198-017-3962-y",
language = "English (US)",
pages = "1--5",
journal = "Osteoporosis International",
issn = "0937-941X",
publisher = "Springer London",

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T1 - Risk of fragility fracture among patients with sarcoidosis

T2 - a population-based study 1976–2013

AU - Ungprasert, P.

AU - Crowson, Cynthia

AU - Matteson, Eric Lawrence

PY - 2017/2/16

Y1 - 2017/2/16

N2 - Summary: Incidence of fragility fracture of a population-based cohort of 345 patients with sarcoidosis was compared with age and sex-matched comparators. The incidence of fragility fracture was higher among patients with sarcoidosis with hazard ratio (HR) of 2.18. Introduction: Several chronic inflammatory disorders increase the risk of fragility fracture. However, little is known about the risk of fragility fracture in patients with sarcoidosis. Methods: This study was conducted using a previously identified population-based cohort of 345 patients with incident sarcoidosis from Olmsted County, Minnesota. Diagnosis of sarcoidosis required physician diagnosis supported by biopsy showing non-caseating granuloma, radiographic evidence of intrathoracic sarcoidosis, and compatible clinical presentations without evidence of other granulomatous diseases. Sex and age-matched subjects randomly selected from the same underlying population were used as comparators. Medical records of cases and comparators were reviewed for baseline characteristics and incident fragility fracture. Results: Fragility fractures were observed in 34 patients with sarcoidosis, corresponding to a cumulative incidence of 5.6% at 10 years, while 18 fragility fractures were observed among comparators for a cumulative incidence of 2.4% at 10 years. The HR of fragility fractures among cases compared with comparators was 2.18 (95% confidence interval [CI], 1.23–3.88). The risk of fragility fracture by site was significantly higher among patients with sarcoidosis, and was due to a higher rate of distal forearm fracture (HR 3.58; 95% CI 1.53–8.40). Statistically non-significant increased risk was also observed in proximal femur (HR 1.66; 95% CI 0.45–6.06) and proximal humerus (HR 3.27; 95% CI 0.66–16.21). Risk of vertebral fracture was not increased (HR 1.00; 95% CI 0.32–3.11). Conclusion: Patients with sarcoidosis have an increased risk of fragility fracture which is primarily driven by the higher incidence of distal forearm fracture.

AB - Summary: Incidence of fragility fracture of a population-based cohort of 345 patients with sarcoidosis was compared with age and sex-matched comparators. The incidence of fragility fracture was higher among patients with sarcoidosis with hazard ratio (HR) of 2.18. Introduction: Several chronic inflammatory disorders increase the risk of fragility fracture. However, little is known about the risk of fragility fracture in patients with sarcoidosis. Methods: This study was conducted using a previously identified population-based cohort of 345 patients with incident sarcoidosis from Olmsted County, Minnesota. Diagnosis of sarcoidosis required physician diagnosis supported by biopsy showing non-caseating granuloma, radiographic evidence of intrathoracic sarcoidosis, and compatible clinical presentations without evidence of other granulomatous diseases. Sex and age-matched subjects randomly selected from the same underlying population were used as comparators. Medical records of cases and comparators were reviewed for baseline characteristics and incident fragility fracture. Results: Fragility fractures were observed in 34 patients with sarcoidosis, corresponding to a cumulative incidence of 5.6% at 10 years, while 18 fragility fractures were observed among comparators for a cumulative incidence of 2.4% at 10 years. The HR of fragility fractures among cases compared with comparators was 2.18 (95% confidence interval [CI], 1.23–3.88). The risk of fragility fracture by site was significantly higher among patients with sarcoidosis, and was due to a higher rate of distal forearm fracture (HR 3.58; 95% CI 1.53–8.40). Statistically non-significant increased risk was also observed in proximal femur (HR 1.66; 95% CI 0.45–6.06) and proximal humerus (HR 3.27; 95% CI 0.66–16.21). Risk of vertebral fracture was not increased (HR 1.00; 95% CI 0.32–3.11). Conclusion: Patients with sarcoidosis have an increased risk of fragility fracture which is primarily driven by the higher incidence of distal forearm fracture.

KW - Epidemiology

KW - Fragility fracture

KW - Glucocorticoids

KW - Sarcoidosis

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