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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 
 Endocrinology and Metabolism(대한내분비학회지), Vol.38(6) : 690-700, 2023-12 
Journal Title
Endocrinology and Metabolism(대한내분비학회지)
Issue Date
Acromegaly ; Hip fractures ; Korea ; Nationwide
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.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Ku, Cheol Ryong(구철룡) ORCID logo https://orcid.org/0000-0001-8693-9630
Kim, Eui Hyun(김의현) ORCID logo https://orcid.org/0000-0002-2523-7122
Kim, Jiwon(김지원)
Moon, Ju Hyung(문주형)
Lee, Eun Jig(이은직) ORCID logo https://orcid.org/0000-0002-9876-8370
Hong, Nam Ki(홍남기) ORCID logo https://orcid.org/0000-0002-8246-1956
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