AMD linked to higher spine, hip fracture risk in osteoporosis
Click Here to Manage Email Alerts
Patients with osteoporosis and age-related macular degeneration had a higher risk for spine and hip fractures vs. those with osteoporosis without AMD, according to results of a population study in Taiwan published in BMJ Open.
“Studies have revealed that macular degeneration and glaucoma suspect would lead to a higher risk of hip fractures,” Chi Chin Sun, MD, PhD, and colleagues wrote. “Therefore, it is important to understand the ocular risk factors and take measures to prevent future fractures in patients with OS [osteoporosis].”
To determine the relationship between AMD and incident fractures among patients with osteoporosis, Sun and colleagues conducted a retrospective, multicenter, nationwide population-based cohort study using data from Taiwan’s National Health Insurance Research Database between 1996 and 2011. Researchers enrolled 13,584 patients (median age, 73.8 years; women, 59.5%) with AMD and 54,336 patients (median age, 73.8 years; women, 59.5%) without AMD. They matched each patient with AMD to four patients without AMD for age, sex and comorbidities. The study’s primary outcome measures included transitions from osteoporosis to spine fracture, hip fracture, humero-radio-ulnar fracture and death.
Compared with patients without AMD, patients with AMD had a “significantly higher” risk for spine fractures (HR = 1.09; 95% CI, 1.04-1.15) and hip fractures (HR = 1.18; 95% CI, 1.08-1.3), but incidence of humero-radio-ulnar fracture was similar in both groups (HR = 0.98; 95% CI, 0.9-1.06).
Risk for death was higher in patients who were older, men and had comorbidities (P < .05) other than hyperthyroidism.
“In conclusion, patients with OS with AMD are at a significantly higher risk of subsequent development of spine and hip fractures, but not humero-radio-ulnar fractures, than matched controls,” researchers wrote.
Perspective
Back to Top
AMD is a leading cause of severe, permanent vision loss affecting approximately 11 million Americans. It greatly impacts one’s quality of life and decreases one’s personal safety. Sun and colleagues looked at the relationship between AMD and the risk for fractures associated with OS, a degenerative joint disease, and found that patients with AMD and OS had a significantly greater risk for spine and hip fractures than patients with OS alone. Though the data from this study might seem intuitive, I hope to see future studies evaluate the similarities between OS and AMD.
While OS is known as the “non-inflammatory arthritis,” it is still associated with some inflammation. Knowing inflammation is a common denominator between both conditions, future studies exploring this association would be welcomed. Further, studies looking at disease severity and treatments throughout the various stages of both AMD and OS will potentially provide greater insight into risk management, psychological impact and available resources. Interestingly, regular exercise, weight loss, assistive devices (like canes) and a healthy diet with plenty of fruits and vegetables are recommended for both conditions. Through this study and hopefully future studies, we will better understand how to mitigate future fractures to provide a more holistic picture in caring for our patients.
Collapse
Click Here to Manage Email Alerts