{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:42:51Z","timestamp":1787010171466,"version":"build-2736575974"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Fujian Provincial Natural Science Foundation Projects","award":["2022J011440"],"award-info":[{"award-number":["2022J011440"]}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1,17]]},"abstract":"<jats:p>\n                    Observational epidemiological studies indicate a higher fracture incidence in rheumatoid arthritis (RA) patients compared to the general population. However, the causal relationship between RA and fracture risk, particularly traumatic and osteoporotic fractures, is not well established. We performed Mendelian randomization (MR) analysis to evaluate the causal relationship between RA and fracture risk. We performed a MR analysis using summary statistics from genome-wide association studies to investigate the causal association between RA and the risk of traumatic fractures at 9 sites and 3 types of osteoporotic fractures. The primary analysis used inverse-variance weighting, supplemented by MR-Egger regression and other methods to assess causal relationships and sensitivity analyses, including heterogeneity and pleiotropy assessments, using R software with appropriate packages. The inverse-variance weighting results demonstrated a causal relationship between genetically predicted RA and an elevated risk of fractures, particularly traumatic fractures of the long bones and osteoporotic fractures, including fractures of shoulder and upper arm (odds ratio [OR]\u2005=\u20051.041, 95% confidence interval [CI]: 1.020\u20131.062,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2005=\u20059.06e-05), fractures of forearm (OR\u2005=\u20051.026, 95% CI: 1.007\u20131.044,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2005=\u2005.006), fracture of femur (OR\u2005=\u20051.036, 95% CI: 1.009\u20131.064,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2005=\u2005.009), fractures of lower leg, including joint (OR\u2005=\u20051.031, 95% CI: 1.016\u20131.047,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2005=\u20056.38e-05), fractures of rib(s), sternum, and thoracic vertebrae (OR\u2005=\u20051.041, 95% CI: 1.018\u20131.064,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2005=\u20054.08e-04), osteoporotic with pathological features (OR\u2005=\u20051.128, 95% CI: 1.071\u20131.188,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2005=\u20055.54e-06), postmenopausal osteoporotic with pathological features (OR\u2005=\u20051.060, 95% CI: 1.002\u20131.123,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2005=\u2005.044), and drug-induced osteoporotic with pathological features (OR\u2005=\u20051.255, 95% CI: 1.124\u20131.400,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2005=\u20055.02e-05). This study highlights the genetic causal link between RA and an increased risk of traumatic and osteoporotic fractures, presenting a new direction for future exploration of the mechanisms underlying RA-related fractures.\n                  <\/jats:p>","DOI":"10.1097\/md.0000000000041248","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T22:02:06Z","timestamp":1737410526000},"page":"e41248","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Rheumatoid arthritis and the risk of fracture: A Mendelian randomization study"],"prefix":"10.1097","volume":"104","author":[{"given":"Yanyan","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, The Affiliated Hospital of Putian University, Putian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive Spinal Surgery, The Affiliated Hospital of Putian University, Putian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhibo","family":"Deng","sequence":"additional","affiliation":[{"name":"Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaizhi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive Spinal Surgery, The Affiliated Hospital of Putian University, Putian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhui","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive Spinal Surgery, The Affiliated Hospital of Putian University, Putian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6463-9933","authenticated-orcid":false,"given":"Xu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive Spinal Surgery, The Affiliated Hospital of Putian University, Putian, China"},{"name":"Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250121","doi-asserted-by":"crossref","first-page":"18001","DOI":"10.1038\/nrdp.2018.1","article-title":"Rheumatoid arthritis.","volume":"4","author":"Smolen","year":"2018","journal-title":"Nat Rev Dis Primers"},{"key":"R2-20250121","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1136\/annrheumdis-2013-204223","article-title":"Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study 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