Musculoskeletal Complications of Hereditary Hemochromatosis: A Case-Control Study
Bibliographic record
Abstract
OBJECTIVE: Arthropathy that mimics osteoarthritis (OA) and osteoporosis (OP) is considered a classic complication of hereditary hemochromatosis (HH) but has never been investigated in a cross-sectional study. We investigated whether HH is associated with increased prevalence of OA and OP and related factors. METHODS: A self-administered questionnaire was completed by 306 patients with HH and 304 age and sex-matched unaffected controls. RESULTS: The mean age of patients was 60.1 ± 11.3 years, and 47.4% were women. More patients with HH than controls had been given a diagnosis of OA: 50.5% vs 28.9% [adjusted OR (aOR) 2.5, 95% CI 1.8-3.6]. Compared with controls, patients with HH had a higher risk of knee (aOR 5.3, 95% CI 1.1-25.6) and hip replacement prosthesis (aOR 5.2, 95% CI 2.2-11.9). More patients than controls had been diagnosed with OP: 23.3% vs 4.6% (aOR 7.3, 95% CI 3.2-17.0). Patients with HH showed an increased prevalence, although not significant, of wrist (aOR 1.7, 95% CI 0.9-3.0) or vertebral fractures (aOR 1.7, 95% CI 0.8-3.8). The severity of iron overload, as defined by a ferritin level > 1000 μg/l at diagnosis, was associated with OA (p = 0.0005), OP (p = 0.01), presence of hip prosthesis (p = 0.04), wrist fractures (p = 0.002), and vertebral fractures (p = 0.02). CONCLUSION: This case-control study strongly suggests a significant association among HH, OA, and OP. Joint involvement can be severe, especially in patients with substantially elevated ferritin levels.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".