Increased Risk of Fracture Among Patients With Iron Overload: A Population-based Matched Cohort Study
Main finding · Any fractureResult — go to the resultHazard ratio 1.55 CI 1.42–1.68Authors' conclusion
This large population-based cohort study found a 55% increased risk of fracture associated with iron overload. The risk was highest among patients with laboratory-confirmed iron overload, highlighting the importance for clinicians to consider initiating osteoporosis therapy in patients with serum ferritin >1000 µg/L to minimize fracture risk.
Study context
- Population
- Patients >18 years with elevated iron or iron overloading disorder diagnosis, 2010–2022, The Health Improvement Network (UK general practice)matched cohort
- Participants
- 20,264 vs 192,956
- Exposure
- Iron overload vs matched controls
- Iron overloadn = 20,264
- Controlsn = 192,956reference
- Outcome
- Any fracture
Methodological detailsmatched with up to 10 controls, time-varying confounder-adjusted Cox proportional hazard models
- Matched with up to 10 controls
- Time-varying confounder-adjusted Cox proportional hazard models
Main finding
As reported in the abstract
Hazard ratio
1.55
CI 1.42–1.68
Observational data: associations, not effects.
Further findings
Fracture by site (hip, vertebral, humerus, forearm)
- Vertebral fractures (highest risk), HR
- 1.97 [1.63-2.10]
- Fracture risk increased at all sites
Any fracture, patients with ferritin >1000 µg/L
- 91% increased risk of any fracture, HR
- 1.91 [1.73-2.16]
Vertebral fractures, patients with ferritin >1000 µg/L
- 2.5-fold increased risk of vertebral fractures, HR
- 2.51 [2.01-3.12]
Fracture, patients without elevated serum ferritin
- No increased risk at any site
Fracture by sex
- Fracture risk similar between sexes
Original publication
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