The Prevalence of Fragility Fractures in a Population of a Region of Southern Italy Affected by Thyroid Disorders

Maccagnano, Giuseppe; Notarnicola, Angela; Pesce, Vito; Mudoni, Simona; Tafuri, Silvio; Moretti, Biagio

doi:10.1155/2016/6017165

Cited by 11 publications

(11 citation statements)

References 27 publications

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“…Hyperthyroidism and hypothyroidism are correlated with low BMD and higher risk of fracture [ 2 ]. In the study of Maccagnano G et al (2016), the incidence rates of fragility fractures were 4.5% and 3.7% in individuals with hyperthyroidism and hypothyroidism, respectively [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Vitamin D Levels, Bone Metabolic Marker Levels, and Bone Mineral Density among Patients with Thyroid Disease: A Cross-Sectional Study

et al. 2020

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Thyroid hormones have a catabolic effect on bone homeostasis. Hence, this study aimed to evaluate serum vitamin D, calcium, and phosphate and bone marker levels and bone mineral density (BMD) among patients with different thyroid diseases. This cross-sectional study included patients with underlying thyroid diseases (n = 64, hyperthyroid; n = 53 euthyroid; n = 18, hypothyroid) and healthy controls (n = 64). BMD was assessed using z-score and left hip and lumbar bone density (g/cm2). The results showed that the mean serum vitamin D Levels of all groups was low (<50 nmol/L). Thyroid patients had higher serum vitamin D levels than healthy controls. All groups had normal serum calcium and phosphate levels. The carboxy terminal collagen crosslink and procollagen type I N-terminal propeptide levels were high in hyperthyroid patients and low in hypothyroid patients. The z-score for hip and spine did not significantly differ between thyroid patients and control groups. The hip bone density was remarkably low in the hyperthyroid group. In conclusion, this study showed no correlation between serum 25(OH)D levels and thyroid diseases. The bone markers showed a difference between thyroid groups with no significant difference in BMD.

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Section: Introductionmentioning

confidence: 99%

Comparison of Vitamin D Levels, Bone Metabolic Marker Levels, and Bone Mineral Density among Patients with Thyroid Disease: A Cross-Sectional Study

et al. 2020

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“…Only one prospective study performed by Tuchendler and Bolanowski in 2013 using 119 participants did not show a negative effect on BMD in the case of hypothyroidism, except in the case of hyperthyroidism (Tables 1-3) [15]. Regarding the incidence of fracture risk in hypothyroidism patients, we found two studies using 92,341 and 16,249 patients, that showed a higher incidence of fractures in these patients (Tables 1-3) [34,35]. As a result, we believe hypothyroidism should be considered a risk factor for osteoporotic fractures.…”

Section: Thyroid Pathologymentioning

confidence: 70%

“…Subclinical hypothyroidism and bone health. Although previous studies have shown that subclinical hypothyroidism has a reduced BMD and an increased risk of fracture, more recent data contradict those findings (Tables 1-3) [33][34][35][36][37]. Since 2014, all of the studies, both prospective and retrospective, have shown no influence of subclinical hypothyroidism on either BMD or fracture risk (Tables 1-3) [25,26,[41][42][43].…”

Section: Thyroid Pathologymentioning

confidence: 99%

The Influence of Thyroid Pathology on Osteoporosis and Fracture Risk: A Review

et al. 2020

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Thyroid hormones are important factors that regulate metabolism and cell differentiation throughout the human body. A complication of thyroid pathology is represented by an alteration of the bone metabolism which can lead to osteoporosis and fragility fractures, known to have a high mortality rate. Although there is a consensus on the negative impact of hyperthyroidism on bone metabolism, when referring to hypothyroidism, subclinical hypothyroidism, or subclinical hyperthyroidism, there is no general agreement. The aim of our review was to update clinicians and researchers about the current data regarding the bone health in hypothyroidism, subclinical hypothyroidism, and subclinical hyperthyroidism patients. Thyroid disorders have an important impact on bone metabolism and fracture risk, such that hyperthyroidism, hypothyroidism, and subclinical hyperthyroidism are associated with a decreased bone mineral density (BMD) and increased risk of fracture. Subclinical hypothyroidism, on the other hand, is not associated with osteoporosis or fragility fractures, and subclinical hyperthyroidism treatment with radioiodine could improve bone health.

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“…In the Apulian population with fragility fractures, the presence of co-mobility is high: 66% have cardiovascular diseases, 44% have rheumatic diseases, and 21% have diabetes. [7][8][9] Hypertension has been postulated as a risk factor for fractures and the relationship is likely independent of bone mineral density (BMD). In a previous Serbian study, around 61% of patients with osteoporosis also were affected by hypertension.…”

Section: Discussionmentioning

confidence: 99%

Frequency of hypertension in hospitalized population with osteoporotic fractures: Epidemiological retrospective analysis of Hospital Discharge Data in the Apulian database for the period 2006–2010

et al. 2017

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Osteoporosis and hypertension are two widespread diseases, which share many of the same risk factors such as advanced age, early menopause, smoking, and physical inactivity. The aim of this study is to examine the association between fragility fractures, anti-hypertensive drugs (subgroup C02, according to the Anatomical Therapeutic Chemical classification system [ATC]), diuretics (subgroup C03), b-blocker (subgroup C07), calcium antagonist (subgroup C08) and renin-angiotensin-aldosterone system regulator (subC09), and drugs administration for osteoporosis among the osteoporotic population of a region of Southern Italy.We retrospectively studied "Hospital Discharge Data" (HDD) in the Apulian database for the period 2006-2010 to find fragility fractures treated with hospitalization in men aged over 65 years and in women aged over 50 years. We then checked the database for drug prescriptions to identify those patients who had taken at least one osteoporosis drug. Within this latter group, based on hospital admissions and prescription records, we identified the patients affected with hypertension.We observed that, between 2006 and 2010, in Apulia, 177,639 patients were hospitalized and diagnosed as having fragility fractures. The prevalence of hypertension patients in Apulia in this period was estimated at 44.3%. In the same region and period, the prevalence of patients with fragility fracture, who also had hypertension, was 80.9%. The percentage of fracture was lowest in the female population aged 50-59 years (52.5%), while the highest was in women aged > 80 years (92.5%). We observed that in hypertensive patients the most frequent site of fracture was the femur (43,638 cases), while the least frequent were the tarsus and metatarsus (742 cases combined). The patients who took angiotensin-converting enzyme (ACE) inhibitor and diuretic drugs presented a higher number of fragility fractures, while the calcium antagonists, beta-blockers, and ATC anti-hypertensive drugs were linked to a reduced incidence of lesions.Hypertension is associated with increased fracture risk in the Apulia population. The bone demineralization effect of this disease should be taken into account during the management of these patients. The different distribution of fragility fractures in relation to anti-hypertensive treatment warrants further investigation.

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The Prevalence of Fragility Fractures in a Population of a Region of Southern Italy Affected by Thyroid Disorders

Cited by 11 publications

References 27 publications

Comparison of Vitamin D Levels, Bone Metabolic Marker Levels, and Bone Mineral Density among Patients with Thyroid Disease: A Cross-Sectional Study

Comparison of Vitamin D Levels, Bone Metabolic Marker Levels, and Bone Mineral Density among Patients with Thyroid Disease: A Cross-Sectional Study

The Influence of Thyroid Pathology on Osteoporosis and Fracture Risk: A Review

Frequency of hypertension in hospitalized population with osteoporotic fractures: Epidemiological retrospective analysis of Hospital Discharge Data in the Apulian database for the period 2006–2010

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