Wu Chieh-Hsin, Tung Yi-Ching, Chai Chee-Yin, Lu Ying-Yi, Su Yu-Feng, Tsai Tai-Hsin, Kuo Keng-Liang, Lin Chih-Lung
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).
Medicine (Baltimore). 2016 Apr;95(16):e3309. doi: 10.1097/MD.0000000000003309.
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.
利用全国性基于人群的数据集调查消化性溃疡疾病（PUD）患者的骨质疏松风险。这项台湾国民健康保险研究数据库（NHIRD）分析纳入了27132名18岁及以上在1996年至2010年期间被诊断为PUD（国际疾病分类第九版临床修订本[ICD - 9 - CM]编码531 - 534）的患者。对照组由27132名随机选取的（年龄和性别匹配）无PUD患者组成。使用Cox比例风险回归模型估计PUD与发生骨质疏松风险之间的关联。在随访期间，PUD组有2538名（9.35%）患者被诊断为骨质疏松，非PUD组有2259名（8.33%）参与者被诊断为骨质疏松。在调整协变量后，PUD组的骨质疏松风险比非PUD组高1.85倍（分别为每1000人年13.99例和5.80例）。骨质疏松在PUD诊断后1年发生。1年随访期在两组之间显示出最高的显著性（风险比[HR]=63.44，95%置信区间[CI]=28.19 - 142.74，P<0.001）。与未使用质子泵抑制剂（PPI）的PUD患者相比，使用PPI的PUD患者骨质疏松风险显著更高（HR=1.17，95%CI=1.03 - 1.34）。本研究揭示了PUD与随后骨质疏松风险之间的显著关联。因此，PUD患者，尤其是接受PPI治疗的患者，应评估其随后的骨质疏松风险，以尽量减少不良事件的发生。
