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. 2023 Dec;38(6):690-700.
doi: 10.3803/EnM.2023.1782. Epub 2023 Oct 30.

Increased Risk of Hip Fracture in Patients with Acromegaly: A Nationwide Cohort Study in Korea

Jiwon Kim  1   2 , Namki Hong  3 , Jimi Choi  4 , Ju Hyung Moon  5   6 , Eui Hyun Kim  5   6 , Eun Jig Lee  3   5 , Sin Gon Kim  4 , Cheol Ryong Ku  3   5
Affiliations

Increased Risk of Hip Fracture in Patients with Acromegaly: A Nationwide Cohort Study in Korea

Jiwon Kim et al. Endocrinol Metab (Seoul). 2023 Dec.

Abstract

Backgruound: Acromegaly leads to various skeletal complications, and fragility fractures are emerging as a new concern in patients with acromegaly. Therefore, this study investigated the risk of fractures in Korean patients with acromegaly.

Methods: We used the Korean nationwide claims database from 2009 to 2019. A total of 931 patients with acromegaly who had never used an osteoporosis drug before and were treated with surgery alone were selected as study participants, and a 1:29 ratio of 26,999 age- and sex-matched osteoporosis drug-naïve controls without acromegaly were randomly selected from the database.

Results: The mean age was 46.2 years, and 50.0% were male. During a median follow-up of 54.1 months, there was no difference in the risks of all, vertebral, and non-vertebral fractures between the acromegaly and control groups. However, hip fracture risk was significantly higher (hazard ratio [HR], 2.73; 95% confidence interval [CI], 1.32 to 5.65), and non-hip and non-vertebral fractures risk was significantly lower (HR, 0.40; 95% CI, 0.17 to 0.98) in patients with acromegaly than in controls; these results remained robust even after adjustment for socioeconomic status and baseline comorbidities. Age, type 2 diabetes mellitus, cardio-cerebrovascular disease, fracture history, recent use of acid-suppressant medication, psychotropic medication, and opioids were risk factors for all fractures in patients with acromegaly (all P<0.05).

Conclusion: Compared with controls, patients surgically treated for acromegaly had a higher risk of hip fractures. The risk factors for fracture in patients with acromegaly were consistent with widely accepted risk factors in the general population.

Keywords: Acromegaly; Hip fractures; Korea; Nationwide.

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Conflict of interest statement

CONFLICTS OF INTEREST

This study was funded by Ipsen. Ipsen had no input into the study design, analysis or interpretation of results. Ipsen performed courtesy review of the manuscript before submission.

Figures

Fig. 1.
Fig. 1.
Flow chart of the study design. ICD-10, International Classification of Disease, 10th Revision.
Fig. 2.
Fig. 2.
The Kaplan-Meier curve of site-specific fractures. (A) All fracture. (B) Vertebral fracture. (C) Non-vertebral fracture. (D) Hip fracture.
See this image and copyright information in PMC

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