Prevalence and Incidence of Fractures in Patients With Nonfunctional Adrenal Tumors
Authors' conclusion
In this cohort study, NFATs were associated with fractures, particularly among younger men; thus, patients with NFATs should have bone health evaluation with appropriate treatment and monitoring, especially in younger men.
Study context
- Population
- Patients with nonfunctional adrenal tumors (NFATs) diagnosed in Sweden between 2005 and 2019 and controls without adrenal tumors; excluded adrenal hormonal excess or previous malignant tumors; median age 66 years
- Participants
- 20,390 vs 125,392
- Exposure
- Patients with NFATs vs controls without adrenal tumors
- NFATsn = 20,390
- Controlsn = 125,392reference
- Outcome
- Prevalence and incidence of fractures, adjusted for sex, age and comorbidities
Methodological detailsnational, adjusted for sex, age and comorbidities
- National
- Adjusted for sex, age and comorbidities
Main finding
As reported in the abstract
Previous fractures (prevalence)
Each group vs controlsEstimate (95% CI)
NFATs
OR 1.39(1.34–1.45)
NFATs
aOR 1.27(1.23–1.33)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Estimate | |
|---|---|---|
| Vertebral fracturesNFATsvs ControlsPrevalent fractures | aOR 1.51 (95% CI 1.33–1.72) | |
| Vertebral fracturesNFATsvs ControlsIncident fractures | aHR 1.83 (95% CI 1.60–2.09) | |
| Fractures in men younger than 50 yearsNFATsvs ControlsPrevalent fractures | aOR 1.45 (95% CI 1.21–1.74) | |
| Fractures in men younger than 50 yearsNFATsvs ControlsIncident fractures | aHR 1.48 (95% CI 1.20–1.82) | |
| 0.512Ratio (log scale) |
Fracture incidence after adrenalectomy
- No association among individuals who had undergone adrenalectomy, aHR
- 1.12 (0.90-1.38) (95% CI)
Sensitivity analyses
- Association between NFATs and fractures remained significant and of similar magnitude in all sensitivity analyses
Original publication
Prevalence and Incidence of Fractures in Patients With Nonfunctional Adrenal Tumors. JAMA Netw Open. Published 1 April 2024. doi:10.
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