Youk Hyun, Lee Hee Young, Lee Eun Young, Kim Yoon Ji, Park Ji Yeong, Choi Hyo Geun, Kim Hyun Sik, Lee Jung Woo
Digital Health Laboratory, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea.
Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
BMC Musculoskelet Disord. 2025 Mar 24;26(1):291. doi: 10.1186/s12891-025-08527-w.
Despite the association between osteoporosis treatment and reduced mortality, evidence on specific-cause mortality is lacking. Therefore, this study explored the association between osteoporosis under treatment and all-cause and specific-cause mortalities using nationwide retrospective cohort data from South Korea.
This study utilized data from the National Health Insurance Service screening cohort of South Korea from 2002 to 2019. Participants with osteoporosis who had undergone treatment at least twice and were diagnosed based on bone densitometry were included. Control groups were matched 1:1 based on age, sex, income, and region. Propensity score overlap weighting was applied to balance covariates. Cox proportional hazards models and Fine-Gray sub-distribution hazard models were used to assess all-cause and specific-cause mortalities across 14 disease categories based on the Korean standard classification of diseases.
Finally, 34,181 participants were included in both osteoporosis and control groups. The largest age group was 55-59 years, with a majority of female participants (81.60%). Osteoporosis under treatment was significantly associated with reduced all-cause mortality with consistent results across various demographic and clinical subgroups. Specific-cause mortality analysis revealed lower mortality due to neoplasms and metabolic diseases and higher mortality from respiratory and muscular diseases. However, increased risks of respiratory and muscular disease-related mortality were observed.
Osteoporosis treatment was associated with reduced all-cause and specific-cause mortalities, particularly from neoplasms and metabolic diseases. Further studies, particularly randomized controlled trials, are required to confirm these results, establish causality, and explore the medication-specific effects on mortality.
尽管骨质疏松症治疗与死亡率降低之间存在关联，但缺乏特定病因死亡率的证据。因此，本研究利用韩国全国范围的回顾性队列数据，探讨接受治疗的骨质疏松症与全因死亡率和特定病因死亡率之间的关联。
本研究使用了韩国国民健康保险服务筛查队列2002年至2019年的数据。纳入了至少接受过两次治疗且根据骨密度测定确诊的骨质疏松症患者。对照组根据年龄、性别、收入和地区进行1:1匹配。采用倾向得分重叠加权法平衡协变量。基于韩国疾病标准分类，使用Cox比例风险模型和Fine-Gray亚分布风险模型评估14种疾病类别的全因死亡率和特定病因死亡率。
最后，骨质疏松症组和对照组均纳入34181名参与者。最大年龄组为55 - 59岁，大多数为女性参与者（81.60%）。接受治疗的骨质疏松症与全因死亡率降低显著相关，在不同人口统计学和临床亚组中结果一致。特定病因死亡率分析显示，肿瘤和代谢疾病导致的死亡率较低，而呼吸和肌肉疾病导致的死亡率较高。然而，观察到呼吸和肌肉疾病相关死亡率的风险增加。
骨质疏松症治疗与全因死亡率和特定病因死亡率降低相关，尤其是肿瘤和代谢疾病导致的死亡率。需要进一步研究，特别是随机对照试验，以证实这些结果，确立因果关系，并探索药物对死亡率的特定影响。
