High risk of osteoporosis and fracture following solid organ transplantation: a population-based study

Frontiers in Endocrinology

Endocrinology

Kuang-Hua Huang¹  Tung-Han Tsai¹  Yih Yang²  Chien-Ying Lee³  Yung-Rung Lai³  Shuo-Yan Gau⁴  Cheng-Yang Huang⁴  Hsin Chen⁵ 

[1] Department of Health Services Administration, China Medical University, Taichung, Taiwan;Department of Obstetrics and Gynecology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan;Department of Pharmacology, Chung Shan Medical University, Taichung, Taiwan;Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan;School of Medicine, Chung Shan Medical University, Taichung, Taiwan;School of Medicine, Chung Shan Medical University, Taichung, Taiwan;Department of Medical Education, Linkou Chang-Gung Memorial Hospital, Taoyuan City, Taiwan;

关键词: solid organ transplantation;    hazard ratios;    osteoporosis;    fracture;    cohort study;   

DOI  :  10.3389/fendo.2023.1167574

 received in 2023-02-16, accepted in 2023-05-04,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundOsteoporosis and fractures increase morbidity and mortality rates after solid organ transplantation (SOT), but few studies have analyzed the risk of osteoporosis and related fractures after SOT. In this retrospective cohort study, we investigated the risk of osteoporosis and fractures in different SOT recipients.MethodsThis study was a retrospective cohort study using a nationally representative database in Taiwan. We collected the data of SOT recipients and used the propensity score matching method to obtain a comparison cohort. To reduce bias, we excluded patients who had been diagnosed with osteoporosis or fracture before inclusion. All participants were followed up until the date of diagnosis as having a pathological fracture, death, or the end of 2018, whichever occurred first. The Cox proportional hazards model was used to investigate the risk of osteoporosis and pathological fracture in SOT recipients.ResultsAfter adjustment for the aforementioned variables, SOT recipients were observed to have a higher risk of osteoporosis (hazard ratio (HR) = 1.46, 95% confidence interval (CI): 1.29–1.65) and fracture (HR: 1.19, 95% CI: 1.01–1.39) than the general individuals. Among the different SOT recipients, the highest risk of fractures was noted in heart or lung transplant recipients, with a HR of 4.62 (95% CI: 2.05–10.44). Among the age groups, patients aged >61 years had the highest HRs for osteoporosis (HR: 11.51; 95% CI, 9.10–14.56) and fracture (HR: 11.75, 95% CI: 8.97–15.40).ConclusionSOT recipients had a higher risk of osteoporosis and related fractures than the general population, with the highest risks observed in patients receiving heart or lung transplants, older patients, and patients with CCI scores of >3.

【 授权许可】

Unknown   
Copyright © 2023 Chen, Lai, Yang, Gau, Huang, Tsai, Huang and Lee