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Risk of bone fractures after the diagnosis of adrenal adenomas: a population-based cohort study.

肾上腺腺瘤诊断后骨折的风险: 一项基于人群的队列研究.

  • 影响因子:5.04
  • DOI:10.1530/EJE-20-1396
  • 作者列表:"Li D","Kaur RJ","Zhang CD","Ebbehoj A","Singh S","Atkinson EJ","Achenbach SJ","Rocca W","Khosla S","Bancos I
  • 发表时间:2021-04-01
Abstract

Objective:Several small studies reported increased prevalence and incidence of asymptomatic vertebral fractures in patients with non-functioning adrenal adenomas and adenomas with mild autonomous cortisol secretion. However, the risk of symptomatic fractures at vertebrae, and at other sites remains unknown. Our objective was to determine the prevalence and incidence of symptomatic site-specific fractures in patients with adrenal adenomas. Design:Population-based cohort study, Olmsted County, Minnesota, USA, 1995-2017. Methods:Participants were the patients with adrenal adenoma and age/sex-matched referent subjects. Patients with overt hormone excess were excluded. Main outcomes measures were prevalence and incidence of bone fractures. Results:Of 1004 patients with adrenal adenomas, 582 (58%) were women, and median age at diagnosis was 63 years (20-96). At the time of diagnosis, patients had a higher prevalence of previous fractures than referent subjects (any fracture: 47.9% vs 41.3%, P = 0.003, vertebral fracture: 6.4% vs 3.6%, P = 0.004, combined osteoporotic sites: 16.6% vs 13.3%, P = 0.04). Median duration of follow-up was 6.8 years (range: 0-21.9 years). After adjusting for age, sex, BMI, tobacco use, prior history of fracture, and common causes of secondary osteoporosis, patients with adenoma had hazard ratio of 1.27 (95% CI: 1.07-1.52) for developing a new fracture during follow up when compared to referent subjects. Conclusions:Patients with adrenal adenomas have higher prevalence of fractures at the time of diagnosis and increased risk to develop new fractures when compared to referent subjects.

摘要

目的: 几项小型研究报道无功能肾上腺腺瘤和伴有轻度自主皮质醇分泌的腺瘤患者中无症状椎体骨折的患病率和发病率增加。然而,椎骨和其他部位有症状骨折的风险仍然未知。我们的目的是确定肾上腺腺瘤患者中症状性部位特异性骨折的患病率和发生率。 设计: 基于人群的队列研究,美国明尼苏达州奥姆斯特德县,1995-2017。 方法: 研究对象为年龄/性别匹配的肾上腺腺瘤患者。排除明显激素过量的患者。主要观察指标为骨折的患病率和发生率。 结果: 1004例肾上腺腺瘤患者中,582例 (58%) 为女性,诊断时的中位年龄为63岁 (20-96岁)。在诊断时,患者先前骨折的患病率高于参考对象 (任何骨折: 47.9% vs 41.3%,P = 0.003,椎骨骨折: 6.4% vs 3.6%,P = 0.004,合并骨质疏松部位: 16.6% vs 13.3%,P = 0.04)。中位随访时间为6.8年 (范围: 0-21.9年)。在调整了年龄、性别、BMI、烟草使用、既往骨折史和继发性骨质疏松症的常见原因后,与参考对象相比,腺瘤患者在随访期间发生新骨折的风险比为1.27 (95% CI: 1.07-1.52)。 结论: 肾上腺腺瘤患者在诊断时骨折的患病率较高,并且与参考对象相比,发生新骨折的风险增加。

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