Increased Risk of Osteoporosis in Patients With Peptic Ulcer Disease: A Nationwide Population-Based Study.
To investigate osteoporosis risk in patients with peptic ulcer disease (PUD) using a nationwide population-based dataset. This Taiwan National Health Insurance Research Database (NHIRD) analysis included 27,132 patients aged 18 years and older who had been diagnosed with PUD (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 531-534) during 1996 to 2010. The control group consisted of 27,132 randomly selected (age- and gender)-matched patients without PUD. The association between PUD and the risk of developing osteoporosis was estimated using a Cox proportional hazard regression model. During the follow-up period, osteoporosis was diagnosed in 2538 (9.35 %) patients in the PUD group and in 2259 (8.33 %) participants in the non-PUD group. After adjusting for covariates, osteoporosis risk was 1.85 times greater in the PUD group compared to the non-PUD group (13.99 vs 5.80 per 1000 person-years, respectively). Osteoporosis developed 1 year after PUD diagnosis. The 1-year follow-up period exhibited the highest significance between the 2 groups (hazard ratio [HR] = 63.44, 95% confidence interval [CI] = 28.19-142.74, P < 0.001). Osteoporosis risk was significantly higher in PUD patients with proton-pump-inhibitors (PPIs) use (HR = 1.17, 95% CI = 1.03-1.34) compared to PUD patients without PPIs use. This study revealed a significant association between PUD and subsequent risk of osteoporosis. Therefore, PUD patients, especially those treated with PPIs, should be evaluated for subsequent risk of osteoporosis to minimize the occurrence of adverse events.
From the Graduate Institute of Medicine (C-HW, C-YC, Y-YL, C-LL), Department of Public Health and Environmental Medicine (Y-CT), Department of Pathology (C-YC), Department of Neurosurgery, Faculty of Medicine, College of Medicine (C-LL), Department of Neurosurgery (C-HW, Y-FS, T-HT, K-LK, C-LL), Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University (C-YC), Institute of Biomedical Sciences, National Sun Yat-Sen University (C-YC), Department of Dermatology, Kaohsiung Veterans General Hospital (Y-YL), and Cosmetic Applications and Management Department, Yuh-Ing Junior College of Health Care & Management, Kaohsiung, Taiwan (Y-YL).
Chieh-Hsin
CH
Wu
Yi-Ching
YC
Tung
Chee-Yin
CY
Chai
Ying-Yi
YY
Lu
Yu-Feng
YF
Su
Tai-Hsin
TH
Tsai
Keng-Liang
KL
Kuo
Chih-Lung
CL
Lin
D000293:Adolescent; D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology*; D010437:Peptic Ulcer / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods*; D011379:Prognosis; D054328:Proton Pump Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
D054328:Proton Pump Inhibitors