Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
Cirrhosis Center Mainz (CCM), University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
PLoS One. 2022 Apr 22;17(4):e0267535. doi: 10.1371/journal.pone.0267535. eCollection 2022.
Portal vein thrombosis (PVT) is a rare but severe disease that often leads to portal hypertension-related complications. It is well-known that patients with portal hypertension associated with liver cirrhosis are at increased risk for bone fractures, however data on the impact of PVT on fracture risk are lacking.
This study aimed to explore the impact of PVT on the incidence of bone fractures in a large German primary care cohort.
Patients with PVT were extensively matched to non-PVT individuals in a 1:5 ratio. The primary outcome of the study was the incidence of any bone fracture.
This study included 596 patients with PVT and 2,980 non-PVT individuals. During five years of follow-up, the cumulative incidence of bone fractures was significantly higher in PVT patients (n = 87, 13.6%) than in those without PVT (n = 186, 6.7%) (p<0.001). In Cox-regression analyses, PVT was positively associated with bone fractures (HR: 2.16; 95% CI: 1.59-2.93). This association was stronger in women (HR: 2.55; 95% CI: 1.65-3.95) than in men (HR: 1.87; 95% CI: 1.22-2.87). The strongest association was observed in the age group 51-60 years (HR: 2.50, 95% CI: 1.40-4.47). The association between PVT and bone fractures was maintained in subgroup analyses of patients with (HR: 2.03, 95% CI: 1.13-3.63) and without liver cirrhosis (HR: 1.82, 95% CI: 1.28-2.58).
PVT is independently associated with a higher incidence of bone fractures. Patients with PVT should be critically evaluated for fracture risk and preventive measures should be considered.
门静脉血栓形成（PVT）是一种罕见但严重的疾病，常导致门静脉高压相关并发症。众所周知，伴有肝硬化的门静脉高压患者发生骨折的风险增加，然而，关于 PVT 对骨折风险影响的数据尚缺乏。
本研究旨在探讨 PVT 在德国大型初级保健队列中对骨折发生率的影响。
将 PVT 患者与非 PVT 患者进行 1:5 比例的广泛匹配。本研究的主要结局是任何骨折的发生率。
本研究纳入了 596 例 PVT 患者和 2980 例非 PVT 个体。在 5 年的随访期间，PVT 患者（n=87，13.6%）骨折的累积发生率明显高于非 PVT 患者（n=186，6.7%）（p<0.001）。在 Cox 回归分析中，PVT 与骨折呈正相关（HR：2.16；95%CI：1.59-2.93）。这种相关性在女性中更强（HR：2.55；95%CI：1.65-3.95），而在男性中则较弱（HR：1.87；95%CI：1.22-2.87）。最强的相关性发生在 51-60 岁年龄组（HR：2.50，95%CI：1.40-4.47）。在伴有（HR：2.03，95%CI：1.13-3.63）和不伴有肝硬化（HR：1.82，95%CI：1.28-2.58）的患者亚组分析中，PVT 与骨折之间的相关性仍然存在。
PVT 与骨折发生率升高独立相关。应仔细评估 PVT 患者的骨折风险，并考虑采取预防措施。
