Low risk for hip fracture and high risk for hip arthroplasty due to osteoarthritis among Swedish farmers

Johansson, Helena; Vala, Cecilie Hongslo; Odén, Anders; Lorentzon, Mattias; McCloskey, Eugène; Kanis, John А.; Harvey, Nicholas C.; Ohlsson, Claes; Lohmander, L. Stefan; Kärrholm, Johan; Mellström, Dan

doi:10.1007/s00198-017-4355-y

Cited by 15 publications

(25 citation statements)

References 45 publications

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“…As heterozygosity for the Z allele causes reduction in AAT, individuals heterozygous for the Z allele may have increased risk of osteoporosis and lower bone mineral density due to increased RANKL-induced bone resorption. Lower bone mineral density has been associated with a lower risk of osteoarthritis [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Pleiotropic associations of heterozygosity for theSERPINA1Z allele in the UK Biobank

et al. 2021

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Homozygosity for the SERPINA1 Z allele causes alpha-1 antitrypsin deficiency, a rare condition that can cause lung and liver disease. However, the effects of Z allele heterozygosity on non-respiratory phenotypes, and on lung function in the general population, remain unclear.We conducted a large population-based study to determine Z allele effects on >2400 phenotypes in UK Biobank (N>303 353).Z allele heterozygosity was strongly associated with increased height (β=1.02 cm, p=3.91×10−68), and with other non-respiratory phenotypes including increased risk of gall bladder disease, reduced risk of heart disease and lower blood pressure, reduced risk of osteoarthritis and reduced bone mineral density, increased risk of headache and enlarged prostate, as well as with blood biomarkers of liver function. Heterozygosity was associated with higher height-adjusted forced expiratory volume in 1 s (FEV1) (β=19.36 mL, p=9.21×10−4) and FEV1/forced vital capacity (FEV1/FVC) (β=0.0031, p=1.22×10−5) in non-smokers, whereas in smokers this protective effect was abolished. Furthermore, we show for the first time that sex modifies the association of the Z allele on lung function.We conclude that Z allele heterozygosity and homozygosity exhibit opposing effects on lung function in the UK population, and that these associations are modified by smoking and sex. In exploratory analyses, heterozygosity for the Z allele also showed pleiotropic associations with non-respiratory health-related traits and disease risk.

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Section: Discussionmentioning

confidence: 99%

Pleiotropic associations of heterozygosity for theSERPINA1Z allele in the UK Biobank

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Pleiotropic effects of heterozygosity for theSERPINA1Z allele in the UK Biobank

Fawcett

Song

Qian

et al. 2020

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Homozygosity for the SERPINA1 Z allele causes alpha-1 antitrypsin deficiency, a rare condition that can cause lung and liver disease. However, the effects of Z allele heterozygosity on non-respiratory phenotypes, and on lung function in the general population, remain unclear. We conducted the largest population-based study to date to determine Z allele effects on >2,400 phenotypes using the UK Biobank study (N>303,353). We detected strong associations between heterozygosity and non-respiratory phenotypes including increased height, increased risk of gall bladder disease, reduced risk of heart disease and lower blood pressure, reduced risk of osteoarthritis and reduced bone mineral density, increased risk of headache and enlarged prostate, as well as with blood biomarkers of liver function. Heterozygosity was associated with higher lung function in non-smokers, but smoking appears to abolish this protective effect. Individuals heterozygous for the Z allele may therefore have altered risk of smoking-induced lung disease and other, non-respiratory conditions.

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“…The relationship between TKR and risk for hip fracture was analysed with the following covariates: age, gender, calendar year for fracture, and latitude. Additional adjustment for income, education, and level of urbanization of place of residence, previously associated with hip fracture [20,21], had no effect on the relationship between hip fracture risk and TKR, so these variables were not included. For more detailed information on distribution of income, education and urbanization, we refer to our previous studies [20,21].…”

Section: Covariatesmentioning

confidence: 99%

Risk for hip fracture before and after total knee replacement in Sweden

et al. 2019

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We studied the risk for hip fracture before and after total knee replacement (TKR) in the entire population in Sweden. Women and men had a low risk for hip fracture before TKR but an increased risk the first year after TKR. Purpose It is known that osteoarthritis is associated with high bone mass. We therefore studied the risk of hip fracture before and after total knee replacement (TKR), risk of different hip fracture types, and risk subdivided in genders and age groups. Methods We followed the total Swedish population born between 1902 and 1952 (n = 4,258,934) during the period 1987-2002 and identified all patients with TKR due to primary OA (n = 39,291), and all patients with hip fracture (n = 195,860) in the Swedish National Inpatient Register. The risk time analyses were based on Poisson regression models. Results The hazard ratio (HR) for hip fracture the last year before TKR was 0.86 (95% CI 0.74 to 1.00) and the first year after 1.26 (95% CI 1.11 to 1.42) compared to individuals without TKR. The HR for femoral neck fracture 0-10 years after TKR was 0.95 (95% CI 0.89 to 1.01) and for trochanteric fracture was 1.13 (95% CI 1.06 to 1.21). The HR for hip fracture in the age group 50-74 was 1.28 (95% CI 1.14 to 1.43) and in the age group 75-90 years was 0.99 (95% CI 0.94 to 1.04) 0-10 years after TKR, compared to individuals without TKR. Conclusion Individuals had a low risk for hip fracture before TKR but an increased risk the first year after TKR. The risk in individuals below age 75 years and for trochanteric fractures was increased after TKR. Possible explanations include changed knee kinematics after a TKR, physical activity level, fall risk, and other unknown factors.

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Low risk for hip fracture and high risk for hip arthroplasty due to osteoarthritis among Swedish farmers

Abstract: Our results indicate that farming, representing an occupation with high physical activity, in men is associated with a lower risk of hip fracture but an increased risk of hip arthroplasty.

Cited by 15 publications

References 45 publications

Pleiotropic associations of heterozygosity for theSERPINA1Z allele in the UK Biobank

Pleiotropic associations of heterozygosity for theSERPINA1Z allele in the UK Biobank

Pleiotropic effects of heterozygosity for theSERPINA1Z allele in the UK Biobank

Risk for hip fracture before and after total knee replacement in Sweden

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