Risk and clinical predictors of osteoporotic fracture in East Asian patients with chronic obstructive pulmonary disease: A population-based cohort study

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Title:	Risk and clinical predictors of osteoporotic fracture in East Asian patients with chronic obstructive pulmonary disease: A population-based cohort study
Authors:	洪炯宗;Lee, Ping-Hsueh;Kok, Victor C.;Chou, Po-Liang;Ku, Ming-Chang;Chen, Yu-Ching;Horng, Jorng-Tzong
Contributors:	資訊電機學院資訊工程學系
Keywords:	Asian;Chronic kidney failure;Chronic obstructive pulmonary disease;Cohort analysis;Comorbidity;COPD;Coronary artery disease;Coronary heart disease;Corticosteroids;Diabetes mellitus;Epidemics;Epidemiology;Fractures;Geriatrics;Global Health;Health insurance;Health risk assessment;Heart diseases;Kidney transplantation;Long bone;Longitudinal studies;Longitudinal study;Lung diseases;Medical research;Obstructive lung disease;Orthopedics;Osteoporosis;Osteoporotic fracture;Population studies;Population-based studies;Population-based study;Rankings;Respiratory Medicine;Sensitivity analysis;Smoking;Vertebrae;Vitamin D
Date:	2016-01-01
Issue Date:	2026-04-23 13:59:57 (UTC+8)
Publisher:	PeerJ Inc.;United States: PeerJ Inc
Abstract:	摘要： Introduction Osteoporosis is becoming an impending epidemic in the Asia-Pacific region. The association between risk of osteoporotic fracture (OTPF) and chronic obstructive pulmonary disease (COPD) in East Asian patients is yet to be fully examined. We conducted a nationwide population-based retrospective cohort study of 98,700 patients aged ≥50 years with or without COPD using a national administrative claims dataset. Materials and Methods The patients were divided into COPD and comparison groups comprising 19,740 and 78,960 patients, respectively. The groups were 1 to 4 matched for age, gender, index date, diabetes mellitus, pre-existing osteoporosis and chronic kidney disease. Information such as the geographic area where southern part represented more sunshine exposure, smoking-related diagnoses, alcohol use disorder, whether there was regular use of inhaled corticosteroids and oral corticosteroids, vitamin D prescriptions, Charlson-Deyo comorbidity index score, and other relevant medical comorbidities were extracted for analysis. They were followed up until OTPF or the end of the year 2013. The outcome measure was an osteoporotic vertebral fracture and other long-bone fractures. A multivariate Cox model was constructed to derive adjusted hazard ratios (aHR) for OTPF with corresponding 95% confidence intervals (CI) after controlling for age, sex, insurance premium category, vitamin D prescription, osteoporosis, and coronary heart disease (CHD). Kaplan–Meier curves of the probability of OTPF-free survival for each cohort were compared using the log-rank test. Patients with OTPF during the first follow-up year were excluded from the overall risk calculation. Contributing factors to the increased risk of OTPF in COPD patients were examined in a sensitivity analysis. Results After a total follow-up of 68,743 patient-years for the COPD group and 278,051 patient-years for the matched comparison group, the HR for OTPF was 1.24 (95% CI [1.02–1.51]; P = 0.0322) in COPD patients. The aHR was increased by 30% for vertebral OTPF (aHR = 1.297, 95% CI [1.020–1.649]; P = 0.0339). Differential lag time sensitivity analysis revealed a progressively elevated risk up to 8-fold increase in women (aHR = 8.0 (95% CI [1.81–35.4]; P < 0.01)) during the fifth follow-up year. COPD patients with pre-existing osteoporosis or given vitamin D prescription harbor a sustained increased risk up to the 5th (aHR, 4.1; 95% CI [1.61–10.35]) and third (aHR, 2.97; 95% CI [1.48–5.97]) follow-up year, respectively. Conclusions Our nationwide population-based cohort study demonstrates that East Asian COPD patients aged 50 and beyond do harbor a modestly increased risk for osteoporotic vertebral fractures particularly for those who are female, have pre-existing osteoporosis or require vitamin D prescription. 其他題名： PeerJ 出版者： United States: PeerJ Inc 出版日期： 2016-10-27 出處： PeerJ (San Francisco, CA), 2016-10, Vol.4, p.e2634, Article e2634 資源來源： ProQuest Open Access Content Collection 版權： COPYRIGHT 2016 PeerJ. Ltd. 版權： 2016 Lee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 版權： 2016 Lee et al. 2016 Lee et al. 識別號： ISSN: 2167-8359 識別號： EISSN: 2167-8359 識別號： DOI: 10.7717/peerj.2634 識別號： PMID: 27812429
Appears in Collections:	[資訊工程學系] 期刊論文

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