Jo Hyen Chul, Jung Gu-Hee, Ok Seong-Ho, Park Ji Eun, Baek Jong Chul
Department of Obstetrics and Gynecology, Gyeongsang National University Changwon Hospital, Changwon-si 51472, Korea.
College of Medicine, Gyeongsang National University, Jinju 52828, Korea.
Healthcare (Basel). 2021 Jan 14;9(1):77. doi: 10.3390/healthcare9010077.
This study aimed to investigate the association between osteoporosis and comorbidity, which are very common in Korea, and develop a treatment strategy to improve bone health based on the findings of the Korean National Health and Nutritional Examination Surveys (KNHANES). This study was based on data obtained from 4060 subjects (1755 males, 2305 females) aged above 60 years in the KNHANES (2016-2017). Well-trained medical staff performed the standard procedures and measured several variables including height, weight, and waist circumference. Interviews and laboratory tests were based on the diagnosis of hyperuricemia, dyslipidemia, type 2 diabetes mellitus (T2DM), osteoporosis, and depression. Comorbidities were defined as a self-reported physician diagnosis. The association of osteoporosis with depression and metabolic disease was assessed statistically using the complex sample analysis method of SPSS. The presence of osteoporosis, dyslipidemia, T2DM, hyperuricemia, obesity, abdominal obesity, and depression was 6.1 ± 0.5%, 15.2 ± 0.7%, 6.5 ± 0.4%, 13.4 ± 0.7%, 30.8 ± 0.8%, 19.4 ± 0.9%, 4.0 ± 0.2%, respectively. After adjusted by age, osteoporotic subjects were significance in the presence of abdominal obesity ( = 0.024, OR 0.80), hyperuricemia ( = 0.013, OR 0.68), dyslipidemia ( < 0.001, OR 1.84), and depression ( < 0.001, OR 2.56), respectively. Subgroup analyses showed dyslipidemia (female subjects, < 0.001, OR 1.04; male subjects, = 0.94, OR 1.09) and depression (female subjects, < 0.001, OR 1.76; male subjects, = 0.51, OR 0.62) were associated with osteoporotic female subjects but not in male subjects. The comorbidity of dyslipidemia and depression in female subjects was associated with osteoporosis and an odds ratio was 13.33 (95% CI: 8.58-20.71) ( < 0.001). The comorbidity of abdominal obesity (female subjects, = 0.75, OR 0.97; male subjects, = 0.94, OR 1.02) and hyperuricemia (female subjects, = 0.27, OR 0.81; male subjects = 0.07, OR 0.35) was not associated with osteoporosis in both Subgroup. The result of this study shows a strong dependency of comorbidity with dyslipidemia and depression in elderly women with osteoporosis. Therefore, efforts to improve dyslipidemia and depression might prevent compromised bone health.
本研究旨在调查骨质疏松症与共病之间的关联(这在韩国非常普遍),并根据韩国国家健康与营养检查调查(KNHANES)的结果制定改善骨骼健康的治疗策略。本研究基于KNHANES(2016 - 2017年)中4060名60岁以上受试者(1755名男性,2305名女性)的数据。训练有素的医务人员执行标准程序并测量了包括身高、体重和腰围在内的多个变量。访谈和实验室检测基于高尿酸血症、血脂异常、2型糖尿病(T2DM)、骨质疏松症和抑郁症的诊断。共病定义为医生的自我报告诊断。使用SPSS的复杂样本分析方法对骨质疏松症与抑郁症和代谢性疾病的关联进行了统计学评估。骨质疏松症、血脂异常、T2DM、高尿酸血症、肥胖、腹型肥胖和抑郁症的发生率分别为6.1±0.5%、15.2±0.7%、6.5±0.4%、13.4±0.7%、30.8±0.8%、19.4±0.9%、4.0±0.2%。在按年龄调整后,骨质疏松症患者在腹型肥胖(P = 0.024,OR 0.80)、高尿酸血症(P = 0.013,OR 0.68)、血脂异常(P < 0.001,OR 1.84)和抑郁症(P < 0.001,OR 2.56)方面具有统计学意义。亚组分析显示,血脂异常(女性受试者,P < 0.001,OR 1.04;男性受试者,P = 0.94,OR 1.09)和抑郁症(女性受试者,P < 0.001,OR 1.76;男性受试者,P = 0.51,OR 0.62)与骨质疏松症女性受试者相关,但与男性受试者无关。女性受试者中血脂异常和抑郁症的共病与骨质疏松症相关,比值比为13.33(95%CI:8.58 - 20.71)(P < 0.001)。腹型肥胖(女性受试者,P = 0.75,OR 0.97;男性受试者,P = 0.94,OR 1.02)和高尿酸血症(女性受试者,P = 0.27,OR 0.81;男性受试者,P = 0.07,OR 0.35)的共病在两个亚组中均与骨质疏松症无关。本研究结果表明,骨质疏松症老年女性的共病与血脂异常和抑郁症密切相关。因此,改善血脂异常和抑郁症的努力可能会预防骨骼健康受损。