Purpose:
Many risk factors have been associated with Dupuytren’s disease (DD), but their contribution is still unclear. Therefore, we aimed to investigate the associations of a wide range of risk factors with the presence of DD in Lifelines, an ongoing prospective population-based cohort study with >165,000 participants initiated in 2006.
Methods:
Presence of DD was determined through questionnaires by self-reported doctor’s diagnosis. The association between demographic, lifestyle, and clinical factors and DD was analyzed by logistic regression adjusted for age, age2 and sex. If p-value<0.25, the variable was selected for inclusion in a multivariable logistic regression model. Related risk factors were grouped into blocks to overcome multicollinearity. Stepwise hierarchical modeling was applied. Nested models were compared using log-likelihood-ratio tests. Sensitivity analysis using controls >55 years was performed to assess the robustness of the findings.
Results:
Overall, 1,320 (2.1%) Lifelines participants reported to have DD. Age, age2, and sex accounted for 7.8% of the variability observed in DD risk. Other risk factors for DD were (osteo)arthritis, and anti-inflammatory or anti-rheumatic products, high-density lipoprotein, triglycerides, alcohol use, and diabetes and diabetes medication, while anthropometric measures of adiposity were negatively associated with DD. Their contribution was relatively small, with the explained variance increasing only to 8.76%.
Conclusions:
Higher age and male sex were the predominant factors increasing DD risk, but anthropometric measures of adiposity, (osteo)arthritis, anti-inflammatory and anti-rheumatic drugs, HDL, triglycerides, alcohol use, diabetes and diabetes medication also contributed significantly to the final risk model for DD. In particular the joint-related factors are of interest, since previous evidence for these risk factors was inconclusive.
Clinical relevance:
Our risk model presents an opportunity for prevention of DD. Future studies should elucidate the role of rheumatoid arthritis in DD. Risk models may possibly enable the creation of accurate individual risk profiles of DD leading to optimization of care.