Risk of fracture in urolithiasis: a population-based cohort study using the health improvement network

Studies have shown decreased bone mineral density in individuals with urolithiasis, but their burden of fracture remains unclear. This study sought to determine whether urolithiasis is associated with increased fracture risk across the lifespan and to delineate sex effects. A population-based retros...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Clinical journal of the American Society of Nephrology 2014-12, Vol.9 (12), p.2133-2140
Hauptverfasser: Denburg, Michelle R, Leonard, Mary B, Haynes, Kevin, Tuchman, Shamir, Tasian, Gregory, Shults, Justine, Copelovitch, Lawrence
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 2140
container_issue 12
container_start_page 2133
container_title Clinical journal of the American Society of Nephrology
container_volume 9
creator Denburg, Michelle R
Leonard, Mary B
Haynes, Kevin
Tuchman, Shamir
Tasian, Gregory
Shults, Justine
Copelovitch, Lawrence
description Studies have shown decreased bone mineral density in individuals with urolithiasis, but their burden of fracture remains unclear. This study sought to determine whether urolithiasis is associated with increased fracture risk across the lifespan and to delineate sex effects. A population-based retrospective cohort study using The Health Improvement Network was performed. The median calendar year for the start of the observation period was 2004 (1994-2012). This study identified 51,785 participants with ≥1 of 87 diagnostic codes for urolithiasis and 517,267 randomly selected age-, sex-, and practice-matched participants. Cox regression was used to estimate the hazard ratio (HR) for first fracture. Fractures identified using diagnostic codes were classified by anatomic site. Median age was 53 years, and 67% of participants were men, confirming their greater urolithiasis burden. Median time from urolithiasis diagnosis to fracture was 10 years. The HR for fracture associated with urolithiasis differed by sex and age (P for interactions, P≤0.003). In men, the adjusted HR was greatest in adolescence (1.55; 95% confidence interval [95% CI], 1.07 to 2.25) with an overall HR of 1.10 (95% CI, 1.05 to 1.16). Urolithiasis was associated with higher fracture risk in women aged 30-79 years (HR, 1.17-1.52), and was highest in women aged 30-39 years (HR, 1.52; 95% CI, 1.23 to 1.87). Peak background fracture rates were highest in boys aged 10-19 years and in women aged 70-79 years. The incidence per 10,000 person-years in participants with versus without urolithiasis was 392 versus 258 in male participants aged 10-19 years, and 263 versus 218 in women aged 70-79 years. Distribution of fracture site within sex did not differ between participants with versus without urolithiasis. Urolithiasis was associated with higher incident fracture risk. The significantly higher risk at times of peak background fracture incidence in adolescent boys and elderly women has profound public health implications.
doi_str_mv 10.2215/CJN.04340514
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4255404</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1634276305</sourcerecordid><originalsourceid>FETCH-LOGICAL-c303t-eb7f7ed4743c04afdbac9565f977ce6c2e8ba563d5fb4b18125a86139ffa72fa3</originalsourceid><addsrcrecordid>eNpVkc9L3UAQxxdRqr725ln26MHY_Zm810NBHmpbpIK00Nsy2cya1SQbdzdP_O-boj7qaQbmw3eG-RByxNmZEFx_Xv_4ecaUVExztUMOuNa6WDH9Z3fbK75PDlO6Z0wpKfQHsi-0VLwS6oC4W58eaHDURbB5ikj9QKcYOp9bD8mnLxToGMapg-zDUNSQsKE2tCFmmvLUPNMp-eGO5hZpi9Dllvp-jGGDPQ6ZDpifQnz4SPYcdAk_vdYF-X158Wv9rbi-ufq-Pr8urGQyF1hXrsJGVUpapsA1NdiVLrVbVZXF0gpc1qBL2WhXq5ovudCwLLlcOQeVcCAX5OtL7jjVPTZ2PiFCZ8boe4jPJoA37yeDb81d2BgltFbzGxfk5DUghscJUza9Txa7DgYMUzK8lEpUpWR6Rk9fUBtDShHddg1n5p8aM6sxb2pm_Pj_07bwmwv5FwwfjSI</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1634276305</pqid></control><display><type>article</type><title>Risk of fracture in urolithiasis: a population-based cohort study using the health improvement network</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Denburg, Michelle R ; Leonard, Mary B ; Haynes, Kevin ; Tuchman, Shamir ; Tasian, Gregory ; Shults, Justine ; Copelovitch, Lawrence</creator><creatorcontrib>Denburg, Michelle R ; Leonard, Mary B ; Haynes, Kevin ; Tuchman, Shamir ; Tasian, Gregory ; Shults, Justine ; Copelovitch, Lawrence</creatorcontrib><description>Studies have shown decreased bone mineral density in individuals with urolithiasis, but their burden of fracture remains unclear. This study sought to determine whether urolithiasis is associated with increased fracture risk across the lifespan and to delineate sex effects. A population-based retrospective cohort study using The Health Improvement Network was performed. The median calendar year for the start of the observation period was 2004 (1994-2012). This study identified 51,785 participants with ≥1 of 87 diagnostic codes for urolithiasis and 517,267 randomly selected age-, sex-, and practice-matched participants. Cox regression was used to estimate the hazard ratio (HR) for first fracture. Fractures identified using diagnostic codes were classified by anatomic site. Median age was 53 years, and 67% of participants were men, confirming their greater urolithiasis burden. Median time from urolithiasis diagnosis to fracture was 10 years. The HR for fracture associated with urolithiasis differed by sex and age (P for interactions, P≤0.003). In men, the adjusted HR was greatest in adolescence (1.55; 95% confidence interval [95% CI], 1.07 to 2.25) with an overall HR of 1.10 (95% CI, 1.05 to 1.16). Urolithiasis was associated with higher fracture risk in women aged 30-79 years (HR, 1.17-1.52), and was highest in women aged 30-39 years (HR, 1.52; 95% CI, 1.23 to 1.87). Peak background fracture rates were highest in boys aged 10-19 years and in women aged 70-79 years. The incidence per 10,000 person-years in participants with versus without urolithiasis was 392 versus 258 in male participants aged 10-19 years, and 263 versus 218 in women aged 70-79 years. Distribution of fracture site within sex did not differ between participants with versus without urolithiasis. Urolithiasis was associated with higher incident fracture risk. The significantly higher risk at times of peak background fracture incidence in adolescent boys and elderly women has profound public health implications.</description><identifier>ISSN: 1555-9041</identifier><identifier>EISSN: 1555-905X</identifier><identifier>DOI: 10.2215/CJN.04340514</identifier><identifier>PMID: 25341724</identifier><language>eng</language><publisher>United States: American Society of Nephrology</publisher><subject>Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Case-Control Studies ; Child ; Female ; Fractures, Bone - epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Original ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Sex Factors ; United Kingdom - epidemiology ; Urolithiasis - epidemiology ; Young Adult</subject><ispartof>Clinical journal of the American Society of Nephrology, 2014-12, Vol.9 (12), p.2133-2140</ispartof><rights>Copyright © 2014 by the American Society of Nephrology.</rights><rights>Copyright © 2014 by the American Society of Nephrology 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c303t-eb7f7ed4743c04afdbac9565f977ce6c2e8ba563d5fb4b18125a86139ffa72fa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4255404/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4255404/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25341724$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Denburg, Michelle R</creatorcontrib><creatorcontrib>Leonard, Mary B</creatorcontrib><creatorcontrib>Haynes, Kevin</creatorcontrib><creatorcontrib>Tuchman, Shamir</creatorcontrib><creatorcontrib>Tasian, Gregory</creatorcontrib><creatorcontrib>Shults, Justine</creatorcontrib><creatorcontrib>Copelovitch, Lawrence</creatorcontrib><title>Risk of fracture in urolithiasis: a population-based cohort study using the health improvement network</title><title>Clinical journal of the American Society of Nephrology</title><addtitle>Clin J Am Soc Nephrol</addtitle><description>Studies have shown decreased bone mineral density in individuals with urolithiasis, but their burden of fracture remains unclear. This study sought to determine whether urolithiasis is associated with increased fracture risk across the lifespan and to delineate sex effects. A population-based retrospective cohort study using The Health Improvement Network was performed. The median calendar year for the start of the observation period was 2004 (1994-2012). This study identified 51,785 participants with ≥1 of 87 diagnostic codes for urolithiasis and 517,267 randomly selected age-, sex-, and practice-matched participants. Cox regression was used to estimate the hazard ratio (HR) for first fracture. Fractures identified using diagnostic codes were classified by anatomic site. Median age was 53 years, and 67% of participants were men, confirming their greater urolithiasis burden. Median time from urolithiasis diagnosis to fracture was 10 years. The HR for fracture associated with urolithiasis differed by sex and age (P for interactions, P≤0.003). In men, the adjusted HR was greatest in adolescence (1.55; 95% confidence interval [95% CI], 1.07 to 2.25) with an overall HR of 1.10 (95% CI, 1.05 to 1.16). Urolithiasis was associated with higher fracture risk in women aged 30-79 years (HR, 1.17-1.52), and was highest in women aged 30-39 years (HR, 1.52; 95% CI, 1.23 to 1.87). Peak background fracture rates were highest in boys aged 10-19 years and in women aged 70-79 years. The incidence per 10,000 person-years in participants with versus without urolithiasis was 392 versus 258 in male participants aged 10-19 years, and 263 versus 218 in women aged 70-79 years. Distribution of fracture site within sex did not differ between participants with versus without urolithiasis. Urolithiasis was associated with higher incident fracture risk. The significantly higher risk at times of peak background fracture incidence in adolescent boys and elderly women has profound public health implications.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Female</subject><subject>Fractures, Bone - epidemiology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>United Kingdom - epidemiology</subject><subject>Urolithiasis - epidemiology</subject><subject>Young Adult</subject><issn>1555-9041</issn><issn>1555-905X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkc9L3UAQxxdRqr725ln26MHY_Zm810NBHmpbpIK00Nsy2cya1SQbdzdP_O-boj7qaQbmw3eG-RByxNmZEFx_Xv_4ecaUVExztUMOuNa6WDH9Z3fbK75PDlO6Z0wpKfQHsi-0VLwS6oC4W58eaHDURbB5ikj9QKcYOp9bD8mnLxToGMapg-zDUNSQsKE2tCFmmvLUPNMp-eGO5hZpi9Dllvp-jGGDPQ6ZDpifQnz4SPYcdAk_vdYF-X158Wv9rbi-ufq-Pr8urGQyF1hXrsJGVUpapsA1NdiVLrVbVZXF0gpc1qBL2WhXq5ovudCwLLlcOQeVcCAX5OtL7jjVPTZ2PiFCZ8boe4jPJoA37yeDb81d2BgltFbzGxfk5DUghscJUza9Txa7DgYMUzK8lEpUpWR6Rk9fUBtDShHddg1n5p8aM6sxb2pm_Pj_07bwmwv5FwwfjSI</recordid><startdate>20141205</startdate><enddate>20141205</enddate><creator>Denburg, Michelle R</creator><creator>Leonard, Mary B</creator><creator>Haynes, Kevin</creator><creator>Tuchman, Shamir</creator><creator>Tasian, Gregory</creator><creator>Shults, Justine</creator><creator>Copelovitch, Lawrence</creator><general>American Society of Nephrology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20141205</creationdate><title>Risk of fracture in urolithiasis: a population-based cohort study using the health improvement network</title><author>Denburg, Michelle R ; Leonard, Mary B ; Haynes, Kevin ; Tuchman, Shamir ; Tasian, Gregory ; Shults, Justine ; Copelovitch, Lawrence</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c303t-eb7f7ed4743c04afdbac9565f977ce6c2e8ba563d5fb4b18125a86139ffa72fa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Case-Control Studies</topic><topic>Child</topic><topic>Female</topic><topic>Fractures, Bone - epidemiology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><topic>United Kingdom - epidemiology</topic><topic>Urolithiasis - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Denburg, Michelle R</creatorcontrib><creatorcontrib>Leonard, Mary B</creatorcontrib><creatorcontrib>Haynes, Kevin</creatorcontrib><creatorcontrib>Tuchman, Shamir</creatorcontrib><creatorcontrib>Tasian, Gregory</creatorcontrib><creatorcontrib>Shults, Justine</creatorcontrib><creatorcontrib>Copelovitch, Lawrence</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical journal of the American Society of Nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Denburg, Michelle R</au><au>Leonard, Mary B</au><au>Haynes, Kevin</au><au>Tuchman, Shamir</au><au>Tasian, Gregory</au><au>Shults, Justine</au><au>Copelovitch, Lawrence</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of fracture in urolithiasis: a population-based cohort study using the health improvement network</atitle><jtitle>Clinical journal of the American Society of Nephrology</jtitle><addtitle>Clin J Am Soc Nephrol</addtitle><date>2014-12-05</date><risdate>2014</risdate><volume>9</volume><issue>12</issue><spage>2133</spage><epage>2140</epage><pages>2133-2140</pages><issn>1555-9041</issn><eissn>1555-905X</eissn><abstract>Studies have shown decreased bone mineral density in individuals with urolithiasis, but their burden of fracture remains unclear. This study sought to determine whether urolithiasis is associated with increased fracture risk across the lifespan and to delineate sex effects. A population-based retrospective cohort study using The Health Improvement Network was performed. The median calendar year for the start of the observation period was 2004 (1994-2012). This study identified 51,785 participants with ≥1 of 87 diagnostic codes for urolithiasis and 517,267 randomly selected age-, sex-, and practice-matched participants. Cox regression was used to estimate the hazard ratio (HR) for first fracture. Fractures identified using diagnostic codes were classified by anatomic site. Median age was 53 years, and 67% of participants were men, confirming their greater urolithiasis burden. Median time from urolithiasis diagnosis to fracture was 10 years. The HR for fracture associated with urolithiasis differed by sex and age (P for interactions, P≤0.003). In men, the adjusted HR was greatest in adolescence (1.55; 95% confidence interval [95% CI], 1.07 to 2.25) with an overall HR of 1.10 (95% CI, 1.05 to 1.16). Urolithiasis was associated with higher fracture risk in women aged 30-79 years (HR, 1.17-1.52), and was highest in women aged 30-39 years (HR, 1.52; 95% CI, 1.23 to 1.87). Peak background fracture rates were highest in boys aged 10-19 years and in women aged 70-79 years. The incidence per 10,000 person-years in participants with versus without urolithiasis was 392 versus 258 in male participants aged 10-19 years, and 263 versus 218 in women aged 70-79 years. Distribution of fracture site within sex did not differ between participants with versus without urolithiasis. Urolithiasis was associated with higher incident fracture risk. The significantly higher risk at times of peak background fracture incidence in adolescent boys and elderly women has profound public health implications.</abstract><cop>United States</cop><pub>American Society of Nephrology</pub><pmid>25341724</pmid><doi>10.2215/CJN.04340514</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1555-9041
ispartof Clinical journal of the American Society of Nephrology, 2014-12, Vol.9 (12), p.2133-2140
issn 1555-9041
1555-905X
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4255404
source MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection
subjects Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Case-Control Studies
Child
Female
Fractures, Bone - epidemiology
Humans
Incidence
Male
Middle Aged
Original
Retrospective Studies
Risk Assessment
Risk Factors
Sex Factors
United Kingdom - epidemiology
Urolithiasis - epidemiology
Young Adult
title Risk of fracture in urolithiasis: a population-based cohort study using the health improvement network
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-18T23%3A51%3A56IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Risk%20of%20fracture%20in%20urolithiasis:%20a%20population-based%20cohort%20study%20using%20the%20health%20improvement%20network&rft.jtitle=Clinical%20journal%20of%20the%20American%20Society%20of%20Nephrology&rft.au=Denburg,%20Michelle%20R&rft.date=2014-12-05&rft.volume=9&rft.issue=12&rft.spage=2133&rft.epage=2140&rft.pages=2133-2140&rft.issn=1555-9041&rft.eissn=1555-905X&rft_id=info:doi/10.2215/CJN.04340514&rft_dat=%3Cproquest_pubme%3E1634276305%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1634276305&rft_id=info:pmid/25341724&rfr_iscdi=true