Saturday, August 4, 2007

Dupuytren's disease: does it really affect 25% of northern Europeans?

We know Peyronie's Disease is more common than once though among white males over age 50, and there's long been thought to be an association with Dupuytren's contracture. So I've been learning a bit about Dupuytren's. I was very surprised to see a news article claiming that 25% of western European men will develop Dupuytren's Disease. That seemed absurdly high. I finally got around to researching that number (italics mine)

Epidemiology of Dupuytren's disease: clinical, ser...[J Clin Epidemiol. 2000] - PubMed Result

1: J Clin Epidemiol. 2000 Mar 1;53(3):291-6. Epidemiology of Dupuytren's disease: clinical, serological, and social assessment. The Reykjavik Study. Gudmundsson KG, Arngrímsson R, Sigfússon N, Björnsson A, Jónsson T. The Health Care Centre, 540, Blonduos, Iceland.

Dupuytren's disease or palmar fibromatosis is a common disabling hand disorder, mainly confined to Caucasians of northwestern European origin. The prevalence of Dupuytren's disease and possible risk factors related to the disease were evaluated in a random sample of 1297 males and 868 females, aged 46 to 74 years. Blood samples were collected and biochemical parameters were evaluated. The possible relation between the disease and clinical, social, and biochemical parameters were estimated with age-adjusted univariate logistic regression analysis. Altogether 19.2% of the males and 4.4% of the female participants had clinical signs of Dupuytren's disease. The prevalence increased with age, from 7.2% among males in the age group 45-49 years up to 39.5% in those 70-74 years old. The more severe form of the disease, finger contractures, was found in 5.0% of the men and 1.4% had required operation, while this was rarely seen among women. In men elevated fasting blood glucose (P < 0.04), low body weight, and body mass index were significantly correlated with the presence of the disease (P < 0.001). Dupuytren's disease was common among heavy smokers (P = 0.02) and those having manual labor as occupation (P = 0.018). These results show that Dupuytren's disease is common in the Icelandic population and occupation and lifestyle seem to be related to the disease.

So the answer is that 25% is perhaps true for north-western Caucasian Europeans, but it refers to early signs of the disease. The prevalence of contractures in this population is only 5%, and Scandinavians appear to have the highest risk of all. On the other hand I was unable to find any literature suggesting Scandinavians were particularly prone to Peyronie's disease. The number is misleading in the context of the news article.

1 comment:

Anonymous said...

As you say, the issue is what you call sick. If it's contractted fingers than obviously the prevalence is low. And it also depends strongly on age, as the Scandinavvian article shows. The highest pertentage that I have seen is actually not in Scandinavia but in Bosnia-Herzegowina. An short overview of geographical distribution of Dupuytren's contracture is on geographic distribution of Dupuytrens.