國家衛生研究院 NHRI:Item 3990099045/10116
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/10116


    Title: Risk of fracture in primary aldosteronism: A population-based cohort study
    Authors: Wu, VC;Chang, CH;Wang, CY;Lin, YH;Kao, TW;Lin, PC;Chu, TS;Chang, YS;Chen, L;Wu, KD;Chueh, SJ
    Contributors: Division of Health Services and Preventive Medicine
    Abstract: 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 1,000 person-years for PA, and 11.2 per 1,000 person-years for APA. In contrast, the incidence rate of fracture at any site was 8.3 per 1,000 person-years in EH controls for PA, and 6.5 per 1,000 person-years in EH controls for APA. 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.
    Date: 2017-04
    Relation: Journal of Bone and Mineral Research. 2017 Apr;32(4):743-752.
    Link to: http://dx.doi.org/10.1002/jbmr.3033
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0884-0431&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000399678900010
    Cited Times(Scopus): https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85013213189
    Appears in Collections:[Li-Kwang Chen] Periodical Articles

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