title: Increased fracture risk in patients with rheumatic disorders and other inflammatory diseases -- a case-control study with 53,108 patients with fracture.
abstract: OBJECTIVE
  To identify the risk of hip and vertebral fractures in patients with rheumatic disorders (RD) and inflammatory bowel diseases (IBD).
  
  
  METHODS
  This population-based case-control study assessed the fracture risk of patients with rheumatoid arthritis, juvenile idiopathic arthritis (JIA), ankylosing spondylitis (AS), systemic lupus erythematosus, polymyositis/dermatomyositis (PM/DM), systemic sclerosis (SSc), Crohn's disease, and ulcerative colitis (UC). The study cohort comprised 53,108 patients with fracture (66% women) and 370,602 age-matched and sex-matched controls. Conditional logistic regression analysis was performed and results were expressed as OR with corresponding 95% CI.
  
  
  RESULTS
  There was a statistically significant increased fracture risk for all RD and for IBD compared with controls. The magnitude of fracture risk was higher for patients with RD (OR 3, 95% CI 2.9-3.2) than for those with IBD (OR 1.6, 1.4-1.8). The OR in RD ranged from 2.6 (1.3-4.9) for SSc to 4 (3.4-4.6) for AS. The largest increased fracture risk for vertebral fractures was seen in AS (OR 7.1, 6-8.4) and for hip fractures in JIA (OR 4.1, 2.4-6.9).
  
  
  CONCLUSIONS
  Our results highlight the existence of an increased fracture risk from a variety of underlying causes in patients with RD and IBD. In many inflammatory diseases, implementation of fracture prevention strategies may be beneficial.
authors.affiliation: Department of Molecular Medicine and Surgery, Section of Orthopedics and Sports Medicine, Karolinska University Hospital/Karolinska Institutet, S-171 76, Stockholm, Sweden. rudiger.weiss@karolinska.se
authors.forename: Rüdiger J
authors.initials: RJ
authors.lastname: Weiss
authors.forename: Marius C
authors.initials: MC
authors.lastname: Wick
authors.forename: Paul W
authors.initials: PW
authors.lastname: Ackermann
authors.forename: Scott M
authors.initials: SM
authors.lastname: Montgomery
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D050723:Fractures, Bone / Q000209:etiology*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012216:Rheumatic Diseases / Q000150:complications*; D012306:Risk