"Modifiable Risk Factors for Prevention in Dupuytren's Disease: A UK Biobank Case-Control Study.".

BACKGROUND: Dupuytren's disease is associated with significant co-morbidity and mortality, and has no existing prevention strategies. It is unclear which modifiable risk factors are most amenable for prevention. This study aimed to determine the strength of modifiable risk factors for Dupuytren's disease, and to investigate associations with other diseases. METHODS: Using UK Biobank data, this case-control study analysed the association between phenotypic variables and Dupuytren's disease through multivariable logistic regression. Exposures assessed were Age, Sex, Body Mass Index, Waist-Hip Ratio, Townsend Deprivation Index, Smoking status, Alcohol intake, Diabetes Mellitus, Hypertension, Cancer, Liver disease, Respiratory disease, Rheumatoid arthritis, Epilepsy, Psoriasis, and Gout. RESULTS: There were 4,148 cases and 397,425 controls. Male sex (OR 3.23, 95%CI 2.90 - 3.60, P=1.07×10 -100), increasing age (OR 1.08, 95% CI 1.07 - 1.08, P=6.78×10 -167), material deprivation (OR 1.01, 95%CI 1.00 - 1.02, P=0.0305), HDL cholesterol (OR 1.76, 95%CI 1.58 - 1.96, P=3.35×10 -24), smoking exposure and alcohol intake were all associated with increased odds of Dupuytren's disease. With increasing obesity class, there was approximately 25% decreased odds (OR 0.774, 95% CI 0.734 - 0.816, P=4.71×10 -21). Diabetes with microvascular or end-organ complications was associated with more than 2.5 times increased odds of Dupuytren's disease (OR 2.59, 95%CI 1.92 - 3.44, P=1.92×10 -10). Within this group, increasing HbA1c values by 10 mmol/mol, or 0.9%, increased the odds by 31% (OR 1.31 95%CI 1.13 - 1.51, P=2.19×10 -4). CONCLUSIONS: Diabetes and poor glycemic control are major risk factors for Dupuytren's disease, which present an opportunity for prevention.