Osteoporotic Bone Fracture Risk Assessment in Latvian Patients with Newly Diagnosed Sarcoidosis

Presentation Number: SAT 317
Date of Presentation: April 1st, 2017

Ieva Ruza*1, Zane Lucane1, Alvils Krams1 and Aivars Lejnieks2
1Riga Eastern Clinical University Hospital, Riga, Latvia, 2Riga Stradins University, Riga, Latvia

Abstract

Background. Sarcoidosis is a granulomatous disease that most commonly affects lungs, but it may also affect any other organ. There is an increased synthesis of calcitriol in sarcoid granulomas. Elevated blood levels of the active form of vitamin D can cause hypercalcemia, hypercalciuria, and it can affect bone metabolism. Many factors, like use of glucocorticoids, abnormal metabolism of calcium and vitamin D, decreased intake of calcium, and decreased level of physical activity, can cause bone loss and increase the risk of fractures in patients with sarcoidosis.

Aim.To evaluate 10-year osteoporotic fracture and hip fracture risk and to analyze factors affecting fracture risk for newly diagnosed patients with sarcoidosis.

Materials and methods. The cross-sectional study included 171 patients (68 men and 103 women) with histologically newly confirmed diagnosis of sarcoidosis who were hospitalized due to suspected disease during the time period from the 1st of January 2013 until the 31st of December 2014 and agreed to participate in the telephone interview in December 2015. QFracture®-2012 1.0 algorithm questions were asked to patients. All data were analyzed using Microsoft Office Excel and IBM SPSS® 22.0.

Results. The age of patients ranged from 30 to 80 years with mean age of 44±12 years. The mean 10-year risk of any osteoporotic fracture in patients was 1.7% (from 0.3% to 20.7%), the mean 10-year risk of hip fracture – 0.4% (from 0% to 13.6%). 10-year risk of any osteoporotic fracture above 11.1% was found in 5.9% of postmenopausal women, and in none of premenopausal women. 10-year risk of any osteoporotic fracture above 2.6% was found in 4.4% of men.

In 7.6% of cases one of the patient’s parents had had an osteoporotic fracture, and in 2.3% of cases there was an osteoporotic fracture in the personal history. 3.3% of patients had had a symptomatic fracture after being diagnosed with sarcoidosis. 26.3% of patients had used medication for the treatment of sarcoidosis, and 21.6% of these patients had used short-term glucocorticoids after diagosis. 33.9% of patients had used vitamin D supplements in the six months preceding the study. 24.0% of patients had a comorbidity that could affect the risk of osteoporotic fracture. Most common comorbidities were asthma and angina pectoris.

Conclusions. An increased 10-year risk of osteoporotic fracture (above 11.1% in women and above 2.6% in men) was found in 5.9% of postmenopausal women, none of premenopausal women, and 4.4% of men. Multiple factors can affect bone metabolism and risk of osteoporotic fracture in patients with sarcoidosis. Osteoporotic fracture risk assessment should include all possible risk factors, and preventive measures should be taken.

 

Nothing to Disclose: IR, ZL, AK, AL