Should clinicians pay more attention to the potential underdiagnosis of osteoporosis in patients with ankylosing spondylitis? A national population-based study in Taiwan

There are limited studies describing the association between ankylosing spondylitis (AS) and osteoporosis. We conducted a nationwide retrospective cohort study to investigate this epidemiologic evidence. Data were obtained from the Taiwan National Health Insurance Research Database (NHIRD). Of 10,29...

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Bibliographic Details
Published in:PloS one 2019-02, Vol.14 (2), p.e0211835-e0211835
Main Authors: Hu, Li-Yu, Lu, Ti, Chen, Pan-Ming, Shen, Cheng-Che, Hung, Yao-Min, Hsu, Chiao-Lin
Format: Article
Language:English
Subjects:
Adult
Age Factors
Aged
Angiogenesis
Ankylosing spondylitis
Biocompatibility
Biology and Life Sciences
Bone density
Chronic obstructive pulmonary disease
Comorbidity
Complications and side effects
Confidence intervals
Databases, Factual
Datasets
Dementia
Demographics
Development and progression
Diagnosis
Dyslipidemia
Emergency medical care
Epidemiology
Female
Fractures
Geriatrics
Gerontology
Health
Health insurance
Health risks
Hospitals
Humans
Hypotheses
Incidence
Insurance
Male
Medical research
Medicine
Medicine and Health Sciences
Metabolic disorders
Middle Aged
National health insurance
Nitrogen dioxide
Online databases
Osteoporosis
Osteoporosis - diagnosis
Osteoporosis - epidemiology
Osteoporosis - etiology
Patients
People and Places
Population
Population studies
Population-based studies
Psychiatry
Regression analysis
Regression models
Risk analysis
Risk Factors
Sex
Sex Factors
Spondylitis
Spondylitis, Ankylosing - complications
Spondylitis, Ankylosing - diagnosis
Spondylitis, Ankylosing - epidemiology
Statistical analysis
Studies
Subgroups
Taiwan - epidemiology
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Summary:There are limited studies describing the association between ankylosing spondylitis (AS) and osteoporosis. We conducted a nationwide retrospective cohort study to investigate this epidemiologic evidence. Data were obtained from the Taiwan National Health Insurance Research Database (NHIRD). Of 10,290 participants, 2,058 patients with AS and 8,232 patients without AS were enrolled from the NHIRD between 2000 to 2013. Cumulative incidences of osteoporosis were compared between 2 groups. Cox regression model was used to estimate the hazard ratio (HR) of developing osteoporosis after controlling for demographic and other co-morbidities, and subgroup analyses were conducted to examine the risk factors for osteoporosis in AS patients. The incidence rate ratio (IRR) of osteoporosis in AS patients was 2.17 times higher than that non-AS group (95% confidence interval [CI], 1.83-2.57). The adjusted HRs of osteoporosis for AS patients after controlling for demographic characteristics and comorbid medical disorders was 1.99 (95% CI 1.68-2.36). Among AS group, after adjustment for major comorbidities, old age (≥65 years, HR 4.32, 95% CI 3.01-6.18), female sex (HR 2.48, 95% CI 1.87-3.28), dyslipidemia (HR 1.44, 95% CI 1.01-2.06) were risk factors associated with osteoporosis. This cohort study demonstrated that patients with AS had a higher risk of developing osteoporosis, especially in those aged over 65, female sex and with dyslipidemia in this patient group.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0211835