Jin Yeonju, Choi Bo Kyu, Lee Jong Woo, Hong Jin Yong, Hong Ickpyo, Baek Min Seok
Department of Occupational Therapy, Graduate School, Yonsei University, Wonju, Republic of Korea.
Department of Neurology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea.
Front Aging Neurosci. 2025 May 21;17:1552381. doi: 10.3389/fnagi.2025.1552381. eCollection 2025.
This study investigated the association between osteoporosis and mortality in patients with Parkinson's disease (PD) and the mediating role of hip fractures.
A retrospective cohort study. Data were obtained from the 2009-2019 Korean National Health Insurance Service-National Sample Cohort databases. We extracted both the International Classification of Diseases, 10th Edition code (G20) and PD registration code (V124) to identify patients with PD. A Cox proportional hazards model was used to analyze the association between osteoporosis and mortality. Mediation analyses were performed to estimate the mediating effect of hip fracture between osteoporosis and mortality in patients with PD.
Of the 2,084 patients with PD, 474 (18.5%) were diagnosed with osteoporosis, and 112 (4.4%) experienced hip fractures after PD diagnosis. In unadjusted mediation analysis, the direct effect of osteoporosis on mortality was not significant (β = 0.0309, 95%: confidence interval [CI] -0.0180-0.0798, = 0.2149), whereas the indirect effect of hip fracture was (β = 0.0130, 95% CI 0.0048-0.0212, = 0.0019). Similarly, in the adjusted model controlling for sex, age at diagnosis, and Charlson Comorbidity Index, the direct effect was not significant (β = 0.0011, 95% CI-0.0508-0.0529, = 0.9675), whereas the indirect effect was (β = 0.0061, 95% CI 0.0009-0.0114, = 0.0223).
This study elucidated the association between osteoporosis and mortality in patients with PD by highlighting the mediating role of hip fractures. These findings thus underscore the importance of managing osteoporosis in patients with PD.
本研究调查了帕金森病（PD）患者骨质疏松症与死亡率之间的关联以及髋部骨折的中介作用。
一项回顾性队列研究。数据来自2009 - 2019年韩国国民健康保险服务 - 全国样本队列数据库。我们提取了国际疾病分类第10版代码（G20）和PD登记代码（V124）以识别PD患者。采用Cox比例风险模型分析骨质疏松症与死亡率之间的关联。进行中介分析以估计髋部骨折在PD患者骨质疏松症和死亡率之间的中介作用。
在2084例PD患者中，474例（18.5%）被诊断为骨质疏松症，112例（4.4%）在PD诊断后发生髋部骨折。在未调整的中介分析中，骨质疏松症对死亡率的直接影响不显著（β = 0.0309，95%置信区间[CI] -0.0180 - 0.0798，P = 0.2149），而髋部骨折的间接影响为（β = 0.0130，95% CI 0.0048 - 0.0212，P = 0.0019）。同样，在控制性别、诊断时年龄和Charlson合并症指数的调整模型中，直接影响不显著（β = 0.0011，95% CI -0.0508 - 0.0529，P = 0.9675），而间接影响为（β = 0.0061，95% CI 0.0009 - 0.0114，P = 0.0223）。
本研究通过强调髋部骨折的中介作用阐明了PD患者骨质疏松症与死亡率之间的关联。因此，这些发现强调了在PD患者中管理骨质疏松症的重要性。
