Increased osteoporosis risk in dermatomyositis or polymyositis independent of the treatments: a population-based cohort
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ORIGINAL ARTICLE
Increased osteoporosis risk in dermatomyositis or polymyositis independent of the treatments: a population-based cohort study with propensity score Cynthia Wei-Sheng Lee1 • Chih-Hsin Muo2,3 • Ji-An Liang4,5 • Fung-Chang Sung4 Chung-Y. Hsu4 • Chia-Hung Kao4,6
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Received: 28 May 2015 / Accepted: 22 September 2015 Ó Springer Science+Business Media New York 2015
Abstract We investigated the relationship between dermatomyositis/polymyositis (DM/PM) and the risk of subsequent osteoporosis development. A population-based retrospective cohort analysis was conducted using the National Health Insurance Research Database and the Catastrophic Illness Patients Database of Taiwan. We included 1179 patients and 4716 patients from 1999 to 2008 as the DM/PM cohort and the comparison cohort, respectively, and calculated the incidence rates of newly diagnosed osteoporosis. We used Cox proportional hazards models stratified on matched pair to assess the effect of DM/PM. The Kaplan–Meier method was applied to estimate the cumulative osteoporosis incidence curves. Patients with DM/PM were 2.99 times more likely to Electronic supplementary material The online version of this article (doi:10.1007/s12020-015-0756-x) contains supplementary material, which is available to authorized users. & Chia-Hung Kao [email protected] 1
Center for Drug Abuse and Addiction, China Medical University Hospital and College of Medicine, China Medical University, Taichung, Taiwan
2
Department of Public Health, China Medical University and Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
3
College of Medicine, China Medical University, Taichung, Taiwan
4
Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 40447, Taiwan
5
Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
6
Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
experience osteoporosis than those without DM/PM. The risk for osteoporosis in DM/PM patients was higher than comparisons in different propensity score quartiles. DM/ PM cohort, no matter treated with or without corticosteroids and immunosuppressant, had a higher risk than the comparison cohort. The incidence of osteoporosis in Taiwan is associated with a priori DM/PM history. This risk was independent of the corticosteroids and immunosuppressant treatment. Keywords Osteoporosis Dermatomyositis/ polymyositis Cohort study Abbreviations BMD Bone mineral density BNHI Bureau of National Health Insurance CIPD Catastrophic Illness Patients Database COPD Chronic obstructive pulmonary disease DM Dermatomyositis DXA Dual energy X-ray absorptiometry IHD Ischemic heart disease IIMs Idiopathic inflammatory myopathies LHID Longitudinal Health Insurance Database NHIRD National Health Insurance Research Database OPD Outpatient department PM Polymyositis
Introduction Dermatomyositis (DM) and polymyositis (PM)—idiopathic infl
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