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

• Published in: Endocrinology and metabolism (Seoul) 2023, 38(6), , pp.690-700
• Main Authors: Kim, Jiwon, Hong, Namki, Choi, Jimi, Moon, Ju Hyung, Kim, Eui Hyun, Lee, Eun Jig, Kim, Sin Gon, Ku, Cheol Ryong
• Format: Article
• Language: English
• Subjects: acromegaly; hip fractures; korea; nationwide; Original; 내과학
• ISSN: 2093-596X; 2093-5978; 2093-5978
• DOI: 10.3803/EnM.2023.1782

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. 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. 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