No increase in fracture incidence in patients treated for thyrotoxicosis in Malmö during 1970-74. A 20-year population-based follow-up.

OBJECTIVES

To study whether there is an increased fracture incidence following thyrotoxicosis.

DESIGN

A case-control study.

SETTING

Malmö University Hospital, Malmö, Sweden.

SUBJECTS

All patients (n = 333) from the population of Malmö who were treated for thyrotoxicosis for the first time during the 5-year period 1970-74. A total of 618 controls were selected from the local municipality registry in Malmö. For each case the aim was to randomly select two age- and gender-specific controls, alive in 1993 and born the same year and month as the case.

MAIN OUTCOME MEASURES

Fracture incidence

RESULTS

Comparing survivors, there were no differences in the percentage of individuals with fractures (all, fragility, non-fragility) between the patients and the controls. Comparing all individuals and including all fractures, the percentage of individuals with fractures in the entire female patient group (24.6%) was lower (P < 0.05) than in female controls (33.1%). There was a similar but non-significant pattern between male patients and controls. The mean number of all fractures was lower in male patients than in controls (P < 0.05), but no significant difference was noted between female patients and controls. For fragility fractures, there were no significant differences in the percentage of individuals with fractures or in the mean number of fractures between female or male patients and controls.

CONCLUSION

In conclusion we found no increased incidence of fragility fractures in patients with previous thyrotoxicosis as compared with controls. Our results do not support the suggestion that screening for osteoporosis should be performed in patients with previous thyrotoxicosis.