https://scholars.lib.ntu.edu.tw/handle/123456789/515033
標題: | Risk of Fracture in Primary Aldosteronism: A Population-Based Cohort Study | 作者: | VIN-CENT WU Chang C.-H. Wang C.-Y. YEN-HUNG LIN Kao T.-W. Lin P.-C. TZONG-SHINN CHU Chang Y.-S. Chen L. KWAN-DUN WU SHIH-CHIEH CHUEH |
公開日期: | 2017 | 出版社: | John Wiley and Sons Inc. | 卷: | 32 | 期: | 4 | 起(迄)頁: | 743-752 | 來源出版物: | Journal of Bone and Mineral Research | 摘要: | Primary aldosteronism (PA) is associated with increased urinary calcium excretion and osteoporosis prevalence. We studied the long-term effect of hyperaldosterone on fracture risk and possible risk mitigation via treatments, by comparing PA patients and their essential hypertension (EH) counterparts extracted by propensity score match. We used a longitudinal population database from the Taiwan National Health Insurance, and used a validated algorithm to identify PA patients diagnosed in 1997–2010. Our sample included 2533 PA patients, including 921 patients with aldosterone-producing adenoma (APA). Our methods for assessing excessive fracture risk included multivariable Cox regression and the competing risk regression. The incidence rate of fracture at any site was 14.4 per 1000 person-years for PA, and 11.2 per 1000 person-years for APA. In contrast, the incidence rate of fracture at any site was 8.3 per 1000 person-years in EH controls for PA, and 6.5 per 1000 person-years in EH controls for APA. Mineralocorticoid receptor antagonist (MRA) treatment might be associated with higher risk of osteoporotic fracture in the whole female PA cohort (subdistribution hazard ratio [SHR] = 2.12, p = 0.008) as well as female APA patients (SHR = 1.15, p = 0.049). As to fracture at any site, MRA treatment was also associated with higher risk; the SHR was 1.88 (p < 0.001) in the whole female PA cohort, and 2.17 (p = 0.019) in female APA patients. PA is tightly associated with higher risk of bone fracture, even in the case where the competing risk of death was controlled. Particularly, female PA patients treated with MRA were confronted with significantly higher risk in bone fracture than their EH controls. ? 2017 American Society for Bone and Mineral Research. ? 2017 American Society for Bone and Mineral Research |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85013213189&doi=10.1002%2fjbmr.3033&partnerID=40&md5=2cb5b003b867d201833c9fe3e06048e6 https://scholars.lib.ntu.edu.tw/handle/123456789/515033 |
ISSN: | 0884-0431 | DOI: | 10.1002/jbmr.3033 | SDG/關鍵字: | antihypertensive agent; mineralocorticoid antagonist; potassium; steroid; mineralocorticoid antagonist; adrenalectomy; adult; age; antihypertensive therapy; Article; blood pressure regulation; cohort analysis; comparative study; controlled study; essential hypertension; female; femoral neck fracture; follow up; fracture; fragility fracture; high risk patient; human; hypokalemia; incidence; longitudinal study; major clinical study; middle aged; mortality; pelvis fracture; population research; primary hyperaldosteronism; risk factor; spine fracture; steroid therapy; supplementation; aged; algorithm; chemically induced; factual database; fragility fracture; hyperaldosteronism; male; sex difference; Adult; Aged; Algorithms; Databases, Factual; Female; Follow-Up Studies; Humans; Hyperaldosteronism; Incidence; Longitudinal Studies; Male; Middle Aged; Mineralocorticoid Receptor Antagonists; Osteoporotic Fractures; Risk Factors; Sex Factors |
顯示於: | 醫學系 |
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