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- Mineral, Bone & Muscle
Big Data Articles (National Health Insurance Service Database) - Increased Risk of Hip Fracture in Patients with Acromegaly: A Nationwide Cohort Study in Korea
- Jiwon Kim, Namki Hong, Jimi Choi, Ju Hyung Moon, Eui Hyun Kim, Eun Jig Lee, Sin Gon Kim, Cheol Ryong Ku
- Endocrinol Metab. 2023;38(6):690-700. Published online October 30, 2023
- DOI: https://doi.org/10.3803/EnM.2023.1782
- 5,952 View
- 146 Download
- 7 Web of Science
- 6 Crossref
-
Abstract
PDF
Supplementary Material
PubReader 
ePub - Background
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. -
Citations
Citations to this article as recorded by
- Long-Term Prognosis and Systemic Impact of Acromegaly: Analyses Utilizing Korean National Health Insurance Data
Sangmo Hong, Kyungdo Han, Cheol-Young Park
Endocrinology and Metabolism.2025; 40(1): 1. CrossRef - Musculoskeletal disease in acromegaly—a population-based registry study
Christian Rosendal, Mai Christiansen Arlien-Søborg, Eigil Husted Nielsen, Claus Larsen Feltoft, Åse Krogh Rasmussen, Marianne Skovsager Andersen, Jens Otto Lunde Jørgensen, Jakob Dal
European Journal of Endocrinology.2025; 192(3): 308. CrossRef - Growth Hormone and Bone: Preclinical and Clinical Perspectives
Kevin C.J. Yuen
Endocrine Practice.2025; 31(9): 1197. CrossRef - Bone Health in Acromegaly
Maria Francesca Birtolo, Simona Jaafar, Giacomo Cristofolini, Gherardo Mazziotti, Andrea G. Lania
Endocrinology and Metabolism Clinics of North America.2025; 54(4): 637. CrossRef - Osteoporosis and fragility fractures in patients with acromegaly: A two-center cross-sectional study
Mauricio Alvarez, Juliana Rincon, Maria Mercedes Ulloa, Oswaldo Rincon, Liliana Mejia, Alejandra Alvarado, Andres Pereira, Mónica Bernal
World Journal of Orthopedics.2025;[Epub] CrossRef - Novel approach to bone comorbidity in resistant acromegaly
Stefano Frara, Matteo Acanfora, Vincenzo Franzese, Maria Luisa Brandi, Marco Losa, Andrea Giustina
Pituitary.2024; 27(6): 813. CrossRef
- Long-Term Prognosis and Systemic Impact of Acromegaly: Analyses Utilizing Korean National Health Insurance Data
- Mineral, Bone & Muscle
Big Data Articles (National Health Insurance Service Database) - Hip Fracture Risk According to Diabetic Kidney Disease Phenotype in a Korean Population
- Seung Eun Lee, Juhwan Yoo, Kyoung-Ah Kim, Kyungdo Han, Han Seok Choi
- Endocrinol Metab. 2022;37(1):148-158. Published online February 28, 2022
- DOI: https://doi.org/10.3803/EnM.2021.1315
- 7,469 View
- 145 Download
- 7 Web of Science
- 8 Crossref
-
Abstract
PDFSupplementary MaterialPubReader ePub
- Background
Diabetic kidney disease (DKD) is associated with an elevated risk of fractures. However, little is known about the association between proteinuric or non-proteinuric DKD and the risk of hip fracture. Thus, we investigated the incidence of hip fractures among Korean adults with type 2 diabetes mellitus (T2DM) stratified by DKD phenotype.
Methods
In this retrospective cohort study using the Korean National Health Insurance Service database, patients with T2DM who received at least one general health checkup between 2009 and 2012 were followed until the date of hip fracture, death, or December 31, 2018. We classified the DKD phenotype by proteinuria and estimated glomerular filtration rate (eGFR), as follows: no DKD (PU−GFR−), proteinuric DKD with normal eGFR (PU+GFR−), non-proteinuric DKD with reduced eGFR (PU−GFR+), and proteinuric DKD with reduced eGFR (PU+GFR+)
Results
The cumulative incidence of hip fractures was highest in the PU+GFR+ group, followed by the PU−GFR+ group and the PU+GFR− group. After adjustment for confounding factors, the hazard ratio (HR) for hip fracture was still highest in the PU+GFR+ group. However, the PU+GFR− group had a higher HR for hip fracture than the PU−GFR+ group (PU+GFR+ : HR, 1.69; 95% confidence interval [CI], 1.57 to 1.81; PU+GFR− : HR, 1.37; 95% CI, 1.30 to 1.46; PU−GFR+ : HR, 1.20; 95% CI, 1.16 to 1.24 using the PU−GFR− group as the reference category).
Conclusion
The present study demonstrated that DKD was significantly associated with a higher risk of hip fracture, with proteinuria as a major determinant. -
Citations
Citations to this article as recorded by- Associations Between Renal Dysfunction Subtypes and Vertebral Fracture in Patients with Type 2 Diabetes: A Longitudinal Study
Nandong Hu, Yiping Zhang, Zicheng Wei, Rui Yu, Yingying Zhang, Xiao Chen
Diabetes, Metabolic Syndrome and Obesity.2025; Volume 18: 1915. CrossRef - Risk of fracture with sodium-glucose cotransporter-2 inhibitors in patients with type 2 diabetes: an updated meta-analysis of randomized controlled trials
Mahdieh Khoshzaban Banisi
International Journal of Physiology, Pathophysiology and Pharmacology.2025; 17(3): 61. CrossRef - Bone Mineral Density and the Risk of Fracture According to eGFR in Postmenopausal Women
Minsang Kim, Kyungdo Han, Jin Kyung Kwon, Jae-ik Oh, Jinsun Lee, Jung Hun Koh, Min Woo Kang, Jeong Min Cho, Semin Cho, Seong Geun Kim, Sehyun Jung, Hyuk Huh, Soojin Lee, Eunjeong Kang, Yaerim Kim, Kwon Wook Joo, Dong Ki Kim, Sehoon Park
Journal of the American Society of Nephrology.2025;[Epub] CrossRef - Proteinuria screening and risk of bone fracture: a retrospective cohort study using a nationwide population-based database
Akira Okada, Akira Honda, Hideaki Watanabe, Yusuke Sasabuchi, Shotaro Aso, Kayo Ikeda Kurakawa, Masaomi Nangaku, Toshimasa Yamauchi, Hideo Yasunaga, Hirotaka Chikuda, Takashi Kadowaki, Satoko Yamaguchi
Clinical Kidney Journal.2024;[Epub] CrossRef - Fracture risks associated with sodium-glucose cotransporter-2 inhibitors in type 2 diabetes patients across eGFR and albuminuria categories: A population-based study in Hong Kong
David Tak Wai Lui, Tingting Wu, Eric Ho Man Tang, Ivan Chi Ho Au, Chi Ho Lee, Yu Cho Woo, Kathryn Choon Beng Tan, Carlos King Ho Wong
Diabetes Research and Clinical Practice.2023; 197: 110576. CrossRef - Diagnose und Management der Osteoporose bei Diabetes mellitus (Update 2023)
Christian Muschitz, Alexandra Kautzky-Willer, Yvonne Winhofer, Martina Rauner, Judith Haschka, Daniel Cejka, Robert Wakolbinger-Habel, Peter Pietschmann
Wiener klinische Wochenschrift.2023; 135(S1): 207. CrossRef - Association between exercise and risk of fractures in new-onset type 2 diabetes: a retrospective cohort study
Seung Eun Lee, Juhwan Yoo, Bong-Seong Kim, Kyoung-Ah Kim, Kyungdo Han, Han Seok Choi
Archives of Osteoporosis.2023;[Epub] CrossRef - Two-Year Changes in Diabetic Kidney Disease Phenotype and the Risk of Heart Failure: A Nationwide Population-Based Study in Korea
Seung Eun Lee, Juhwan Yoo, Han Seok Choi, Kyungdo Han, Kyoung-Ah Kim
Diabetes & Metabolism Journal.2023; 47(4): 523. CrossRef
- Associations Between Renal Dysfunction Subtypes and Vertebral Fracture in Patients with Type 2 Diabetes: A Longitudinal Study
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