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Elevated morbidity and mortality in patients with chronic idiopathic hypophosphatemia: a nationwide cohort study

BACKGROUND: Chronic idiopathic hypophosphatemia (CIH) induced by X-linked hypophosphatemic rickets or tumor-induced osteomalacia is a rare inherited or acquired disorder. However, due to its rarity, little is known about the epidemiology and natural course of CIH. Therefore, we aimed to identify the...

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Autores principales: Kim, Kyoung Jin, Song, Ji Eun, Kim, Ji Hyun, Hong, Namki, Kim, Sin Gon, Lee, Juneyoung, Rhee, Yumie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10448510/
https://www.ncbi.nlm.nih.gov/pubmed/37635983
http://dx.doi.org/10.3389/fendo.2023.1229750
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author Kim, Kyoung Jin
Song, Ji Eun
Kim, Ji Hyun
Hong, Namki
Kim, Sin Gon
Lee, Juneyoung
Rhee, Yumie
author_facet Kim, Kyoung Jin
Song, Ji Eun
Kim, Ji Hyun
Hong, Namki
Kim, Sin Gon
Lee, Juneyoung
Rhee, Yumie
author_sort Kim, Kyoung Jin
collection PubMed
description BACKGROUND: Chronic idiopathic hypophosphatemia (CIH) induced by X-linked hypophosphatemic rickets or tumor-induced osteomalacia is a rare inherited or acquired disorder. However, due to its rarity, little is known about the epidemiology and natural course of CIH. Therefore, we aimed to identify the prevalence and long-term health outcomes of CIH patients. METHODS: Using the Korean Health Insurance Review and Assessment claims database, we evaluated the incidence of hypophosphatemia initially diagnosed from 2003 to 2018. After excluding secondary conditions that could change serum phosphorus levels, we identified 154 patients (76 men and 78 women) with non-secondary and non-renal hypophosphatemia. These hypophosphatemic patients were compared at a ratio of 1:10 with age-, sex-, and index-year-matched controls (n = 1,540). RESULTS: In the distribution of age at diagnosis, a large peak was observed in patients aged 1–4 years and small peaks were observed in ages from 40–70 years. The age-standardized incidence rate showed non-statistically significant trend from 0.24 per 1,000,000 persons in 2003 to 0.30 in 2018. Hypophosphatemic patients had a higher risk of any complication (adjusted hazard ratio [aHR], 2.17; 95% confidence interval [CI], 1.67–2.69) including cardiovascular outcomes, chronic kidney disease, hyperparathyroidism, osteoporotic fractures, periodontitis, and depression. Hypophosphatemic patients also had higher risks of mortality and hospitalization than the controls (aHR, 3.26; 95% CI, 1.83–5.81; and aHR, 2.49; 95% CI, 1.97–3.16, respectively). CONCLUSION: This first nationwide study of CIH in South Korea found a bimodal age distribution and no sex differences among patients. Hypophosphatemic patients had higher risks of complications, mortality, and hospitalization compared to age- and sex-matched controls.
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spelling pubmed-104485102023-08-25 Elevated morbidity and mortality in patients with chronic idiopathic hypophosphatemia: a nationwide cohort study Kim, Kyoung Jin Song, Ji Eun Kim, Ji Hyun Hong, Namki Kim, Sin Gon Lee, Juneyoung Rhee, Yumie Front Endocrinol (Lausanne) Endocrinology BACKGROUND: Chronic idiopathic hypophosphatemia (CIH) induced by X-linked hypophosphatemic rickets or tumor-induced osteomalacia is a rare inherited or acquired disorder. However, due to its rarity, little is known about the epidemiology and natural course of CIH. Therefore, we aimed to identify the prevalence and long-term health outcomes of CIH patients. METHODS: Using the Korean Health Insurance Review and Assessment claims database, we evaluated the incidence of hypophosphatemia initially diagnosed from 2003 to 2018. After excluding secondary conditions that could change serum phosphorus levels, we identified 154 patients (76 men and 78 women) with non-secondary and non-renal hypophosphatemia. These hypophosphatemic patients were compared at a ratio of 1:10 with age-, sex-, and index-year-matched controls (n = 1,540). RESULTS: In the distribution of age at diagnosis, a large peak was observed in patients aged 1–4 years and small peaks were observed in ages from 40–70 years. The age-standardized incidence rate showed non-statistically significant trend from 0.24 per 1,000,000 persons in 2003 to 0.30 in 2018. Hypophosphatemic patients had a higher risk of any complication (adjusted hazard ratio [aHR], 2.17; 95% confidence interval [CI], 1.67–2.69) including cardiovascular outcomes, chronic kidney disease, hyperparathyroidism, osteoporotic fractures, periodontitis, and depression. Hypophosphatemic patients also had higher risks of mortality and hospitalization than the controls (aHR, 3.26; 95% CI, 1.83–5.81; and aHR, 2.49; 95% CI, 1.97–3.16, respectively). CONCLUSION: This first nationwide study of CIH in South Korea found a bimodal age distribution and no sex differences among patients. Hypophosphatemic patients had higher risks of complications, mortality, and hospitalization compared to age- and sex-matched controls. Frontiers Media S.A. 2023-08-10 /pmc/articles/PMC10448510/ /pubmed/37635983 http://dx.doi.org/10.3389/fendo.2023.1229750 Text en Copyright © 2023 Kim, Song, Kim, Hong, Kim, Lee and Rhee https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Kim, Kyoung Jin
Song, Ji Eun
Kim, Ji Hyun
Hong, Namki
Kim, Sin Gon
Lee, Juneyoung
Rhee, Yumie
Elevated morbidity and mortality in patients with chronic idiopathic hypophosphatemia: a nationwide cohort study
title Elevated morbidity and mortality in patients with chronic idiopathic hypophosphatemia: a nationwide cohort study
title_full Elevated morbidity and mortality in patients with chronic idiopathic hypophosphatemia: a nationwide cohort study
title_fullStr Elevated morbidity and mortality in patients with chronic idiopathic hypophosphatemia: a nationwide cohort study
title_full_unstemmed Elevated morbidity and mortality in patients with chronic idiopathic hypophosphatemia: a nationwide cohort study
title_short Elevated morbidity and mortality in patients with chronic idiopathic hypophosphatemia: a nationwide cohort study
title_sort elevated morbidity and mortality in patients with chronic idiopathic hypophosphatemia: a nationwide cohort study
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10448510/
https://www.ncbi.nlm.nih.gov/pubmed/37635983
http://dx.doi.org/10.3389/fendo.2023.1229750
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