{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:16:19Z","timestamp":1787656579158,"version":"build-2736575974"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2000,11,1]],"date-time":"2000-11-01T00:00:00Z","timestamp":973036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Localized disruption of bone architecture leads to an increased risk of pathological fractures in patients with Paget's disease, but the impact of the disease on overall fracture risk is unknown. We addressed this issue among 236 Olmsted County, Minnesota residents (107 women and 129 men) first diagnosed with Paget's disease from 1950 through 1994. These subjects (mean \u00b1 SD age at diagnosis, 69.6 \u00b1 12.2 years) were followed subsequently for 2798 person-years. During this period of observation, 33 pathological fractures were attributed to Paget's disease (1 skull, 11 vertebra, 1 shaft\/distal humerus, 1 pelvis, 6 proximal femur, 2 shaft\/distal femur, and 11 tibia\/fibula). Excluding the fractures through pagetic bone, there was no increase in overall fracture risk in this cohort (standardized incidence ratio [SIR], 1.2; 95% CI, 0.9-1.4). However, there was a statistically significant increase in the risk of subsequent vertebra (SIR, 3.0; 95% CI, 2.2-4.1) and rib fractures (SIR, 1.7; 95% CI, 1.1-2.4) but not fractures of the proximal femur (SIR, 0.6; 95% CI, 0.3-1.1) or distal forearm (SIR, 1.4; 95% CI, 0.7-2.5). Thus, unselected patients with Paget's disease in the community, who mostly have mild disease, have a significantly increased risk of vertebral fractures, although this may relate partly to increased surveillance. Additional work is needed to clarify the relationship between Paget's disease and vertebral fractures and to identify individuals at increased risk for more aggressive therapy.<\/jats:p>","DOI":"10.1359\/jbmr.2000.15.11.2123","type":"journal-article","created":{"date-parts":[[2006,4,27]],"date-time":"2006-04-27T02:09:39Z","timestamp":1146103779000},"page":"2123-2128","source":"Crossref","is-referenced-by-count":40,"title":["Fracture Risk Among Patients with Paget's Disease: A Population-Based Cohort Study"],"prefix":"10.1093","volume":"15","author":[{"suffix":"III","given":"L. Joseph","family":"Melton","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Metabolism and Nutrition, Department of Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, U.S.A."},{"name":"Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert D.","family":"Tiegs","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Metabolism and Nutrition, Department of Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth J.","family":"Atkinson","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Michael","family":"O'Fallon","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2009,12,2]]},"reference":[{"key":"2024020714083403200_bib1","first-page":"415","volume-title":"Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism","author":"Siris","year":"1999","edition":"4th Ed."},{"key":"2024020714083403200_bib2","first-page":"105","volume-title":"Paget's Disease of Bone","author":"Barry","year":"1969"},{"key":"2024020714083403200_bib3","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/0049-0172(94)90036-1","article-title":"Bone histomorphometry and skeletal distribution of Paget's disease of bone","volume":"23","author":"Meunier","year":"1994","journal-title":"Semin Arthritis Rheum"},{"issue":"Suppl 2","key":"2024020714083403200_bib4","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/jbmr.5650140203","article-title":"Cell biology of Paget's disease","volume":"14","author":"Reddy","year":"1999","journal-title":"J Bone Miner Res"},{"key":"2024020714083403200_bib5","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1002\/jbmr.5650090111","article-title":"Interleukin-6, IL-6 receptor, and IL-6 nuclear factor gene expression in Paget's disease","volume":"9","author":"Hoyland","year":"1994","journal-title":"J Bone Miner Res"},{"key":"2024020714083403200_bib6","doi-asserted-by":"crossref","first-page":"4226","DOI":"10.4049\/jimmunol.144.11.4226","article-title":"IL-6 stimulates osteoclast-like multinucleated cell formation in long term human marrow cultures by inducing IL-1 release","volume":"144","author":"Kurihara","year":"1990","journal-title":"J Immunol"},{"key":"2024020714083403200_bib7","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1172\/JCI115584","article-title":"Interleukin 6: A potential autocrine\/paracrine factor in Paget's disease of bone","volume":"89","author":"Roodman","year":"1992","journal-title":"J Clin Invest"},{"key":"2024020714083403200_bib8","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/B978-012068700-8\/50020-7","volume-title":"Metabolic Bone Disease and Clinically Related Disorders","author":"Singer","year":"1998","edition":"3rd Ed."},{"issue":"Suppl","key":"2024020714083403200_bib9","doi-asserted-by":"crossref","first-page":"197S","DOI":"10.1016\/8756-3282(95)00502-1","article-title":"Drug therapy for vertebral fractures in osteoporosis: Evidence that decreases in bone turnover and increases in bone mass both determine antifracture efficacy","volume":"18","author":"Riggs","year":"1996","journal-title":"Bone"},{"key":"2024020714083403200_bib10","first-page":"110","volume-title":"Clinical features and complications. 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