title: Psoriasis, fracture risk and bone mineral density: the HUNT Study, Norway.
abstract: BACKGROUND
  An association between psoriasis and osteoporosis has been reported.
  
  
  OBJECTIVE
  To investigate, in a large prospective population-based Norwegian study, whether psoriasis is associated with increased risk of forearm or hip fracture; to investigate the cross-sectional association between psoriasis and bone mineral density (BMD) T-score in a subpopulation.
  
  
  METHODS
  Hospital-derived fracture data from Nord-Trøndelag County (1995-2013) were linked to psoriasis information, BMD measurements and lifestyle factors from the third survey of the Nord-Trøndelag Health Study 2006-08 (HUNT3); socioeconomic data from the National Education Database; and use of medication from the Norwegian Prescription Database.
  
  
  RESULTS
  Among 48 194 participants in HUNT3, we found no increased risk of forearm or hip fracture in 2804 patients with self-reported psoriasis [overall age- and sex-adjusted hazard ratio 1·03, 95% confidence interval (CI) 0·82-1·31]. No clear association was found between psoriasis and mean BMD T-score; overall age- and sex-adjusted differences in total hip, femoral neck and lumbar spine BMD T-scores were 0·02 (95% CI -0·11 to 0·14), 0·05 (95% CI -0·06 to 0·17) and 0·07 (95% CI -0·09 to 0·24), respectively. No clear association was found between psoriasis and prevalent osteoporosis in either total hip, femoral neck or lumbar spine; overall age- and sex-adjusted odds ratio was 0·77 (95% CI 0·54-1·10). Associations did not change substantially after adjustment for education, smoking, systemic steroid use and body mass index.
  
  
  CONCLUSIONS
  We found no association between psoriasis and risk of fracture. The study did not indicate reduced BMD T-score or higher prevalence of osteoporosis among patients with psoriasis.
authors.affiliation: Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Dermatology, St. Olavs Hospital, Trondheim University Hospital, Norway.
authors.forename: E H
authors.initials: EH
authors.lastname: Modalsli
authors.affiliation: Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Norway.
authors.forename: B O
authors.initials: BO
authors.lastname: Åsvold
authors.affiliation: Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: P R
authors.initials: PR
authors.lastname: Romundstad
authors.affiliation: Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: A
authors.initials: A
authors.lastname: Langhammer
authors.affiliation: Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Rheumatology, St. Olavs Hospital, Trondheim University Hospital, Norway.|Nord-Trøndelag Hospital Trust, Levanger, Norway.
authors.forename: M
authors.initials: M
authors.lastname: Hoff
authors.affiliation: Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: S
authors.initials: S
authors.lastname: Forsmo
authors.affiliation: Centro Studi Gruppo Italiano Studi Epidemiologici in Dermatologia (GISED), Bergamo, Italy.|Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Naldi
authors.affiliation: Department of Dermatology, St. Olavs Hospital, Trondheim University Hospital, Norway.|Department of Cancer Research and Molecular Medicine, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: M
authors.initials: M
authors.lastname: Saunes
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015519:Bone Density / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D005272:Femur Neck / Q000502:physiology; D005542:Forearm; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008159:Lumbar Vertebrae / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D011565:Psoriasis / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D012307:Risk Factors; D055815:Young Adult