ArticleJournal of internal medicine2025
Increased risk of osteoporotic fractures and osteoporosis in patients with Addison's disease in Sweden: A nationwide population-based cohort study.
Article in Journal of internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Work Loss and Income Before and After Diagnosis of Addison's Disease: A Population-Based Longitudinal Study.The Journal of clinical endocrinology and metabolism · 2026Article
- Addisonian crisis following osteoprotective therapy in a patient with secondary adrenal insufficiency.JCEM case reports · 2026Article
- Sex differences in clinical and metabolic outcomes of glucocorticoid replacement therapy in adrenal insufficiency.Pituitary · 2026Review
- Increased risk of osteoporotic fractures and osteoporosis in patients with Addison's disease in Sweden: A nationwide population-based cohort study.Journal of internal medicine · 2025Article
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Abstract
backgroundThe risk of major osteoporotic fractures (MOFs) and osteoporosis in patients with autoimmune Addison's disease (AAD) is unclear.
objectiveTo investigate the risk of MOF in patients with AAD and the possible correlation with adrenal hormone replacement doses.
methodsSwedish national health registers were used to identify 1869 subjects with AAD and 16,844 matched controls. The primary outcome was MOF, and the secondary outcome was treatment with osteoporosis medications. Marginal Cox models were used to compare time-to-event outcomes. The study period spanned from 1 July 2005 until 31 December 2020. Individuals at risk were followed from inclusion until censored or the end of the study period.
resultsA total of 77 patients with AAD (7.1/1000 person-years [PY]), and 387 matched controls (3.9/1000 PY) were diagnosed with MOF. The risk of MOF was higher in patients with AAD compared to matched controls, with an adjusted hazard ratio (aHR) of 1.82 (95% confidence interval [CI], 1.41-2.35) and increased in both male and female patients, with aHR of 2.51 (95% CI, 1.56-4.02) and 1.65 (95% CI, 1.22-2.24), respectively. Patients with AAD had an increased risk of treatment with osteoporosis medications: aHR 3.25 (95% CI, 2.71-3.99), compared to controls. No significant differences in MOF rates were observed between patients treated with intermediate or high doses of glucocorticoids compared to low doses (p = 0.967 and p = 0.580, respectively). Similarly, stratification by mineralocorticoid dose (<0.10 vs. ≥0.10 mg/day) showed no significant association regarding MOF (p = 0.915).
conclusionsThe risk of MOF is increased in patients with AAD without any apparent correlation to adrenal hormone replacement doses.
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