Retrospective Analysis of Factors Associated with Fracture in 714 Patients with Polymyalgia Rheumatica

Area of Science:

• Gerontology
• Rheumatology
• Osteoporosis Research

Background:

• Polymyalgia rheumatica (PMR) is a common condition in the elderly, associated with an elevated risk of fractures.
• Glucocorticosteroid (GC) treatment and chronic inflammation are potential contributors to fracture risk in PMR patients.
• Risk factors for fractures in PMR remain understudied, and hip structure analysis (HSA) has not been previously investigated in this population.

Purpose of the Study:

• To investigate the association between fracture risk and densitometry data in patients with PMR.
• To determine the influence of hip structure analysis (HSA) measurements on fracture risk in PMR.
• To identify key predictors of fracture in elderly individuals diagnosed with PMR.

Main Methods:

• A retrospective study analyzed 714 patients with PMR undergoing bone density assessment.
• Data collected included demographics, GC use, lifestyle factors, fracture history, bone mineral density (BMD), and HSA measurements from DEXA scans.
• Logistic regression models, adjusted for age and sex, were used to assess fracture risk, with model fit evaluated by AUC.

Main Results:

• Lumbar and femoral BMD measurements were significantly associated with fracture risk.
• Specific associations were found for right femur (OR 0.062), left femur (OR 0.098), right femoral neck (OR 0.078), left femoral neck (OR 0.104), and lumbar vertebrae L1-L4.
• Hip structure analysis revealed that cross-sectional area was the only parameter significantly associated with fracture (OR 0.988).

Conclusions:

• Lumbar bone density, particularly L2, showed the strongest association with fracture risk in PMR patients.
• Hip structure analysis, specifically cross-sectional area, also demonstrated a significant association with fracture.
• Further prospective studies are required to confirm these findings and elucidate predictive factors for future fractures in PMR.