Department of Physical Medicine and Rehabilitation, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
Department of Family Medicine, Buddhist Tzu Chi General Hospital, No. 707, Sec. 3, Chung Yang Rd, Hualien, 97002, Taiwan.
Eur J Clin Microbiol Infect Dis. 2019 Feb;38(2):365-372. doi: 10.1007/s10096-018-3436-y. Epub 2018 Nov 20.
This study aimed to investigate the association between herpes zoster (HZ) and the risks of osteoporosis and fracture. We conducted a nationwide retrospective cohort study using the National Health Insurance Research Database of Taiwan. The study enrolled 63,786 patients: 31,893 diagnosed with HZ between 2000 and 2012 were included in the HZ cohort, and 31,893 matched controls without HZ were included in the non-HZ cohort, with 1:1 exact matching for age, sex, and index year. Hazard ratios (HRs) were calculated for the risks of osteoporosis and fracture according to the HZ status using the Cox proportional hazards regression models. During a mean follow-up period of 6.0 years, 5597 and 4639 patients in the HZ and non-HZ cohorts, respectively, developed osteoporosis or fractures (incidence rate: 29.8 vs. 23.8 per 1000 person-years). HZ diagnosis was significantly associated with an elevated risk of developing osteoporosis or fracture (adjusted HR [aHR] = 1.20, p < 0.001). On analyses for each individual event, the HZ cohort had significantly increased risks for all events, including osteoporosis (aHR = 1.32, p < 0.001), hip fracture (aHR = 1.34, p < 0.001), vertebral fracture (aHR = 1.38, p < 0.001), and other fractures (aHR = 1.10, p < 0.001) compared with the non-HZ cohort. Patients with postherpetic neuralgia had especially higher risks of osteoporosis and fracture. Age- and sex-stratified analyses also revealed similar patterns. In conclusion, HZ was independently associated with an increased risk of osteoporosis and fracture. Further studies are required to investigate its underlying mechanisms.
本研究旨在探讨带状疱疹（HZ）与骨质疏松症和骨折风险之间的关联。我们使用台湾全民健康保险研究数据库进行了一项全国性回顾性队列研究。该研究纳入了 63786 名患者：2000 年至 2012 年间诊断为 HZ 的 31893 名患者纳入 HZ 队列，31893 名年龄、性别和索引年均匹配的无 HZ 患者纳入非 HZ 队列，采用 1:1 精确匹配。使用 Cox 比例风险回归模型根据 HZ 状态计算骨质疏松症和骨折的风险比（HRs）。在平均 6.0 年的随访期间，HZ 和非 HZ 队列中分别有 5597 名和 4639 名患者发生骨质疏松症或骨折（发生率：HZ 队列为 29.8/1000 人年，非 HZ 队列为 23.8/1000 人年）。HZ 诊断与发生骨质疏松症或骨折的风险升高显著相关（调整后的 HR[aHR] = 1.20，p < 0.001）。对每个单独事件的分析显示，HZ 队列发生所有事件的风险显著增加，包括骨质疏松症（aHR = 1.32，p < 0.001）、髋部骨折（aHR = 1.34，p < 0.001）、椎体骨折（aHR = 1.38，p < 0.001）和其他骨折（aHR = 1.10，p < 0.001）与非 HZ 队列相比。患有疱疹后神经痛的患者发生骨质疏松症和骨折的风险尤其更高。年龄和性别分层分析也显示出相似的模式。总之，HZ 与骨质疏松症和骨折风险增加独立相关。需要进一步研究以探讨其潜在机制。
