title: Prevalence of Dupuytren disease in The Netherlands.
abstract: BACKGROUND
  Dupuytren disease is a fibroproliferative disease of palmar fascias of the hand. The prevalence of Dupuytren disease and the association with potential risk factors have been the subject of several studies, although there is a paucity of such data from The Netherlands.
  
  
  METHODS
  To study the prevalence of Dupuytren disease, the authors drew a random sample of 1360 individuals, stratified by age, from the northern part of The Netherlands. Of this sample, 763 individuals aged 50 to 89 years participated in this cross-sectional study. The authors examined both hands for signs of Dupuytren disease, and a questionnaire was conducted to identify potential risk factors. The effects of these risk factors were investigated using logistic regression analysis. Additional analyses were performed to develop a logistic prediction model for the prevalence of Dupuytren disease.
  
  
  RESULTS
  The prevalence of Dupuytren disease was 22.1 percent. Nodules and cords were seen in 17.9 percent, and flexion contractures were present in 4.2 percent of the study population. Prevalence increased with age, from 4.9 percent in participants aged 50 to 55 years to 52.6 percent among those aged 76 to 80 years. Men were more often affected than women; 26.4 percent versus 18.6 percent, respectively (p=0.007). Other significant risk factors were previous hand injury, excessive alcohol consumption, familial occurrence of Dupuytren disease, and presence of Ledderhose disease.
  
  
  CONCLUSIONS
  The results show a high prevalence of Dupuytren disease in The Netherlands, particularly the nodular form. Using the developed logistic prediction model, the prevalence of Dupuytren disease can be estimated, based on the presence of significant risk factors.
  
  
  METHODS
  Risk, III.
authors.affiliation: Groningen, The Netherlands From the Departments of Plastic Surgery and Epidemiology, University of Groningen, University Medical Center.
authors.forename: Rosanne
authors.initials: R
authors.lastname: Lanting
authors.forename: Edwin R
authors.initials: ER
authors.lastname: van den Heuvel
authors.forename: Bram
authors.initials: B
authors.lastname: Westerink
authors.forename: Paul M N
authors.initials: PMN
authors.lastname: Werker
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004387:Dupuytren Contracture / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D019637:Orthopedic Procedures / Q000379:methods; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
references.citation: Eadington DW, Patrick AW, Frier BM. Association between connective tissue changes and smoking habit in type 2 diabetes and in non-diabetic humans. Diabetes Res Clin Pract. 1991;11:121–125
references.citation: Arafa M, Noble J, Royle SG, Trail IA, Allen J. Dupuytren’s and epilepsy revisited. J Hand Surg Br. 1992;17:221–224
references.citation: Geoghegan JM, Forbes J, Clark DI, Smith C, Hubbard R. Dupuytren’s disease risk factors. J Hand Surg Br. 2004;29:423–426
references.citation: Godtfredsen NS, Lucht H, Prescott E, Sørensen TI, Grønbaek M. A prospective study linked both alcohol and tobacco to Dupuytren’s disease. J Clin Epidemiol. 2004;57:858–863
references.citation: Burge P. Genetics of Dupuytren’s disease. Hand Clin. 1999;15:63–71
references.citation: Hu FZ, Nystrom A, Ahmed A, et al. Mapping of an autosomal dominant gene for Dupuytren’s contracture to chromosome 16q in a Swedish family. Clin Genet. 2005;68:424–429
references.citation: Hindocha S, John S, Stanley JK, Watson SJ, Bayat A. The heritability of Dupuytren’s disease: Familial aggregation and its clinical significance. J Hand Surg Am. 2006;31:204–210
references.citation: Dolmans GH, Werker PM, Hennies HC, et al.Dutch Dupuytren Study Group; German Dupuytren Study Group; LifeLines Cohort Study; BSSH-GODD Consortium. Wnt signaling and Dupuytren’s disease. N Engl J Med. 2011;365:307–317
references.citation: Bergenudd H, Lindgärde F, Nilsson BE. Prevalence of Dupuytren’s contracture and its correlation with degenerative changes of the hands and feet and with criteria of general health. J Hand Surg Br. 1993;18:254–257
references.citation: Gudmundsson KG, Arngrímsson R, Sigfússon N, Björnsson A, Jónsson T. Epidemiology of Dupuytren’s disease: Clinical, serological, and social assessment. The Reykjavik Study. J Clin Epidemiol. 2000;53:291–296
references.citation: Mitra A, Goldstein RY. Dupuytren’s contracture in the black population: A review. Ann Plast Surg. 1994;32:619–622
references.citation: Slattery D. Review: Dupuytren’s disease in Asia and the migration theory of Dupuytren’s disease. ANZ J Surg. 2010;80:495–499
references.citation: Hindocha S, McGrouther DA, Bayat A. Epidemiological evaluation of Dupuytren’s disease incidence and prevalence rates in relation to etiology. Hand (NY). 2009;4:256–269
references.citation: Zerajic D, Finsen V. Dupuytren’s disease in Bosnia and Herzegovina: An epidemiological study. BMC Musculoskelet Disord. 2004;5:10
references.citation: Degreef I, De Smet L. A high prevalence of Dupuytren’s disease in Flanders. Acta Orthop Belg. 2010;76:316–320
references.citation: Beighton P, Valkenburg HA. Bone and joint disorders on Tristan da Cunha. S Afr Med J. 1974;48:743–747
references.citation: Finsen V, Dalen H, Nesheim J. The prevalence of Dupuytren’s disease among 2 different ethnic groups in northern Norway. J Hand Surg Am. 2002;27:115–117
references.citation: Mikkelsen OA. The prevalence of Dupuytren’s disease in Norway: A study in a representative population sample of the municipality of Haugesund. Acta Chir Scand. 1972;138:695–700
references.citation: Noble J, Heathcote JG, Cohen H. Diabetes mellitus in the aetiology of Dupuytren’s disease. J Bone Joint Surg Br. 1984;66:322–325
references.citation: Hurst LC, Badalamente MA, Hentz VR, et al.CORD I Study Group. Injectable collagenase clostridium histolyticum for Dupuytren’s contracture. N Engl J Med. 2009;361:968–979
references.citation: Pess GM, Pess RM, Pess RA. Results of needle aponeurotomy for Dupuytren contracture in over 1,000 fingers. J Hand Surg Am. 2012;37:651–656
references.citation: van Rijssen AL, Gerbrandy FS, Ter Linden H, Klip H, Werker PM. A comparison of the direct outcomes of percutaneous needle fasciotomy and limited fasciectomy for Dupuytren’s disease: A 6-week follow-up study. J Hand Surg Am. 2006;31:717–725
references.citation: Gudmundsson KG, Arngrímsson R, Sigfússon N, Jónsson T. Increased total mortality and cancer mortality in men with Dupuytren’s disease: A 15-year follow-up study. J Clin Epidemiol. 2002;55:5–10
references.citation: Mikkelsen OA, Høyeraal HM, Sandvik L. Increased mortality in Dupuytren’s disease. J Hand Surg Br. 1999;24:515–518
references.citation: Wilbrand S, Ekbom A, Gerdin B. A cohort study linked increased mortality in patients treated surgically for Dupuytren’s contracture. J Clin Epidemiol. 2005;58:68–74
references.citation: Su CK, Patek AJ Jr. Dupuytren’s contracture: Its association with alcoholism and cirrhosis. Arch Intern Med. 1970;126:278–281
references.citation: Arafa M, Steingold RF, Noble J. The incidence of Dupuytren’s disease in patients with rheumatoid arthritis. J Hand Surg Br. 1984;9:165–166
references.citation: Guğmundsson KG, Arngrímsson R, Sigfússon N, Jónsson T. Prevalence of joint complaints amongst individuals with Dupuytren’s disease: From the Reykjavík study. Scand J Rheumatol. 1999;28:300–304
references.citation: Burke FD, Proud G, Lawson IJ, McGeoch KL, Miles JN. An assessment of the effects of exposure to vibration, smoking, alcohol and diabetes on the prevalence of Dupuytren’s disease in 97,537 miners. J Hand Surg Eur Vol. 2007;32:400–406
references.citation: Bridgman JF. Periarthritis of the shoulder and diabetes mellitus. Ann Rheum Dis. 1972;31:69–71
references.citation: Eadington DW, Patrick AW, Collier A, Frier BM. Limited joint mobility, Dupuytren’s contracture and retinopathy in type 1 diabetes: Association with cigarette smoking. Diabet Med. 1989;6:152–157
references.citation: Chammas M, Bousquet P, Renard E, Poirier JL, Jaffiol C, Allieu Y. Dupuytren’s disease, carpal tunnel syndrome, trigger finger, and diabetes mellitus. J Hand Surg Am. 1995;20:109–114
references.citation: Ardic F, Soyupek F, Kahraman Y, Yorgancioglu R. The musculoskeletal complications seen in type II diabetics: Predominance of hand involvement. Clin Rheumatol. 2003;22:229–233
references.citation: Savaş S, Köroğlu BK, Koyuncuoğlu HR, Uzar E, Celik H, Tamer NM. The effects of the diabetes related soft tissue hand lesions and the reduced hand strength on functional disability of hand in type 2 diabetic patients. Diabetes Res Clin Pract. 2007;77:77–83
references.citation: Kischer CW, Speer DP. Microvascular changes in Dupuytren’s contracture. J Hand Surg Am. 1984;9:58–62
references.citation: Badalamente MA, Hurst LC, Grandia SK, Sampson SP. Platelet-derived growth factor in Dupuytren’s disease. J Hand Surg Am. 1992;17:317–323
references.citation: Burge P, Hoy G, Regan P, Milne R. Smoking, alcohol and the risk of Dupuytren’s contracture. J Bone Joint Surg Br. 1997;79:206–210
references.citation: Mackenney RP. A population study of Dupuytren’s contracture. Hand. 1983;15:155–161