title: A nationwide population cohort study: irritable bowel syndrome is a risk factor of osteoporosis.
abstract: BACKGROUND
  The goal of the study is to determine the relationship between irritable bowel syndrome (IBS) and osteoporosis in Taiwan.
  
  
  METHODS
  We collected data from the National Health Insurance (NHI) program in Taiwan. The sample in this study consisted of 31,892 patients enrolled from 2000 to 2009 and diagnosed by the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). We divided the sample into 2 cohorts based on whether they had IBS, and formed subgroups based on age, sex, enrolment year, and enrolment month.
  
  
  RESULTS
  Age and gender did not differ statistically among the 2 cohorts. Results show that IBS is more correlated with urbanization and the occupation of business. The IBS cohort had a higher incidence of osteoporosis than the non-IBS cohort (6.90 vs 4.15 per 1000 person-years; HR=1.65, 955 CI=1.54-1.77). Female patients aged 40-59years had the highest risk of developing osteoporosis (HR=4.42, 95% CI=3.37-5.79 in the IBS cohort; HR=4.41, 95% CI=3.67-5.29 in the non-IBS cohort, respectively). In IBS patients less than 40years of age, female patients had a significant 2.18-fold greater risk of developing osteoporosis than male patients (HR=2.18, 95% CI=1.09-4.38).
  
  
  CONCLUSIONS
  IBS is a risk factor for osteoporosis in Taiwan.
authors.affiliation: Department of Anesthesiology, Buddhist Tzu Chi General Hospital, Taichung Branch, Taichung, Taiwan.
authors.forename: Chia-Ming
authors.initials: CM
authors.lastname: Yen
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Muo
authors.affiliation: Department of Nuclear Medicine, E-DA Hospital, Kaohsiung, Taiwan.
authors.forename: Ming-Chia
authors.initials: MC
authors.lastname: Lin
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Shih-Ni
authors.initials: SN
authors.lastname: Chang
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan.
authors.forename: Yen-Jung
authors.initials: YJ
authors.lastname: Chang
authors.affiliation: Department of Nuclear Medicine PET Center, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009790:Occupations / Q000706:statistics & numerical data; D010024:Osteoporosis / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data
keywords: Cohort study; Irritable bowel syndrome; National Health Insurance; Osteoporosis