title: Chronic obstructive pulmonary disease and allied conditions is a strong independent risk factor for osteoporosis and pathologic fractures: a population-based cohort study.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease and allied conditions (COPD) is frequently associated with various comorbidities. This study examined the association between osteoporosis and pathologic fractures in a sample of patients with COPD.
  
  
  METHODS
  In this cohort study, claims data from the National Health Insurance Research Database of Taiwan were used to evaluate the risk between COPD and osteoporosis. Using data from the Longitudinal Health Insurance Database 2000, we conducted a retrospective cohort study by investigating patients aged 20 years and older who were newly diagnosed with COPD and comparing them with controls without COPD during 2000-2010. In addition, we used univariable and multivariable Cox proportional hazards regression models to measure the association between COPD and the risk of osteoporosis.
  
  
  RESULTS
  Our results revealed that COPD was significantly associated with a high risk of osteoporosis, regardless of whether the patients with COPD were corticosteroid users and irrespective of age and sex. After adjustment for covariates, the COPD patients exhibited a 1.54-fold higher risk of developing osteoporosis (hazard ratio 1.54, 95% confidence interval 1.44-1.64). COPD was a stronger risk factor for osteoporosis in men. Moreover, patients with severe COPD had a higher risk of osteoporosis or pathologic fractures.
  
  
  CONCLUSIONS
  This study revealed that COPD, which shares the characteristics of inflammatory diseases, is associated with a higher risk of osteoporosis after adjustment for comorbidities.
authors.affiliation: From the Department of Health Services Administration, China Medical University, Taichung, Taiwan, Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan, Department of Public Health, China Medical University, Taichung, Taiwan.
authors.forename: S-J
authors.initials: SJ
authors.lastname: Chen
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: W-C
authors.initials: WC
authors.lastname: Liao
authors.affiliation: From the Department of Health Services Administration, China Medical University, Taichung, Taiwan.
authors.forename: K-H
authors.initials: KH
authors.lastname: Huang
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan, College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: C-L
authors.initials: CL
authors.lastname: Lin
authors.affiliation: From the Department of Health Services Administration, China Medical University, Taichung, Taiwan.
authors.forename: W-C
authors.initials: WC
authors.lastname: Tsai
authors.affiliation: Department of Healthcare Administration, Asia University, Taichung, Taiwan.
authors.forename: P-T
authors.initials: PT
authors.lastname: Kung
authors.affiliation: From the Department of Health Services Administration, China Medical University, Taichung, Taiwan, Department of Medical Research, Taichung Veterans General Hospital, Taiwan and.
authors.forename: K-H
authors.initials: KH
authors.lastname: Chang
authors.affiliation: From the Department of Health Services Administration, China Medical University, Taichung, Taiwan, Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan d10040@mail.cmuh.org.tw.
authors.forename: C-H
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology / Q000209:etiology*; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000209:etiology*; D011239:Prednisolone / Q000627:therapeutic use; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone