Association of age-related macular degeneration on fracture risks among osteoporosis population: a nationwide population-based cohort study
Objectives Visual impairment is an important risk factor for fracture in the elderly population. Age-related macular degeneration (AMD) is the leading cause of irreversible visual impairment in elderly people. This study was conducted to explore the relationship between AMD and incident fractures in...
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e037028.full |
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| author | Bing-Yu Chen Chi Chin Sun Ting-Shuo Huang Tsai-Sheng Fu Chia-Yi Lee Fang-Ping Chen |
| author_facet | Bing-Yu Chen Chi Chin Sun Ting-Shuo Huang Tsai-Sheng Fu Chia-Yi Lee Fang-Ping Chen |
| author_sort | Bing-Yu Chen |
| collection | DOAJ |
| description | Objectives Visual impairment is an important risk factor for fracture in the elderly population. Age-related macular degeneration (AMD) is the leading cause of irreversible visual impairment in elderly people. This study was conducted to explore the relationship between AMD and incident fractures in patients with osteoporosis (OS).Design Retrospective analysis of Taiwan’s National Health Insurance Research Database (NHIRD).Setting A multicenter study conducted in Taiwan.Participants and controls The current study used the NHIRD in Taiwan between 1996 and 2011. A total of 13 584 and 54 336 patients with OS were enrolled in the AMD group and the non-AMD group, respectively.Intervention Patients with OS were included from the Taiwan’s NHIRD after exclusion, and each patient with AMD was matched for age, sex and comorbidities to four patients with non-AMD OS, who served as the control group. A Cox proportional hazard model was used for the multivariable analysis.Primary outcome measures Transitions for OS to spine fracture, OS to hip fracture, OS to humero-radio-ulnar fracture and OS to death.Results The risks of spine and hip fractures were significantly higher in the AMD group (HR=1.09, 95% CI=1.04 to 1.15, p<0.001; HR=1.18; 95% CI=1.08 to 1.30, p=0.001, respectively) than in the non-AMD group. The incidence of humero-radio-ulnar fracture between AMD and non-AMD individuals was similar (HR=0.98; 95% CI=0.90 to 1.06; p=0.599). However, the risk of death was higher in patients with OS with older age, male sex and all types of comorbidity (p<0.05), except for hyperthyroidism (p=0.200).Conclusion Patients with OS with AMD had a greater risk of spine and hip fractures than did patients without AMD. |
| format | Article |
| id | doaj-art-d2e02af970344d87aa22b79040de5e28 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-d2e02af970344d87aa22b79040de5e282025-01-08T22:25:10ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2020-037028Association of age-related macular degeneration on fracture risks among osteoporosis population: a nationwide population-based cohort studyBing-Yu Chen0Chi Chin Sun1Ting-Shuo Huang2Tsai-Sheng Fu3Chia-Yi Lee4Fang-Ping Chen5Department of Medical Research and Development, Chang Gung Memorial Hospital, Keelung, TaiwanDepartment of Ophthalmology, Chang Gung Memorial Hospital, Keelung, TaiwanDepartment of General Surgery, Chang Gung Memorial Hospital, Keelung, TaiwanDepartment of Orthopedic Surgery, Chang Gung Memorial Hospital, Keelung, TaiwanDepartment of Ophthalmology, Show Chwan Memorial Hospital, Changhua, TaiwanDepartment of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung, TaiwanObjectives Visual impairment is an important risk factor for fracture in the elderly population. Age-related macular degeneration (AMD) is the leading cause of irreversible visual impairment in elderly people. This study was conducted to explore the relationship between AMD and incident fractures in patients with osteoporosis (OS).Design Retrospective analysis of Taiwan’s National Health Insurance Research Database (NHIRD).Setting A multicenter study conducted in Taiwan.Participants and controls The current study used the NHIRD in Taiwan between 1996 and 2011. A total of 13 584 and 54 336 patients with OS were enrolled in the AMD group and the non-AMD group, respectively.Intervention Patients with OS were included from the Taiwan’s NHIRD after exclusion, and each patient with AMD was matched for age, sex and comorbidities to four patients with non-AMD OS, who served as the control group. A Cox proportional hazard model was used for the multivariable analysis.Primary outcome measures Transitions for OS to spine fracture, OS to hip fracture, OS to humero-radio-ulnar fracture and OS to death.Results The risks of spine and hip fractures were significantly higher in the AMD group (HR=1.09, 95% CI=1.04 to 1.15, p<0.001; HR=1.18; 95% CI=1.08 to 1.30, p=0.001, respectively) than in the non-AMD group. The incidence of humero-radio-ulnar fracture between AMD and non-AMD individuals was similar (HR=0.98; 95% CI=0.90 to 1.06; p=0.599). However, the risk of death was higher in patients with OS with older age, male sex and all types of comorbidity (p<0.05), except for hyperthyroidism (p=0.200).Conclusion Patients with OS with AMD had a greater risk of spine and hip fractures than did patients without AMD.https://bmjopen.bmj.com/content/10/9/e037028.full |
| spellingShingle | Bing-Yu Chen Chi Chin Sun Ting-Shuo Huang Tsai-Sheng Fu Chia-Yi Lee Fang-Ping Chen Association of age-related macular degeneration on fracture risks among osteoporosis population: a nationwide population-based cohort study BMJ Open |
| title | Association of age-related macular degeneration on fracture risks among osteoporosis population: a nationwide population-based cohort study |
| title_full | Association of age-related macular degeneration on fracture risks among osteoporosis population: a nationwide population-based cohort study |
| title_fullStr | Association of age-related macular degeneration on fracture risks among osteoporosis population: a nationwide population-based cohort study |
| title_full_unstemmed | Association of age-related macular degeneration on fracture risks among osteoporosis population: a nationwide population-based cohort study |
| title_short | Association of age-related macular degeneration on fracture risks among osteoporosis population: a nationwide population-based cohort study |
| title_sort | association of age related macular degeneration on fracture risks among osteoporosis population a nationwide population based cohort study |
| url | https://bmjopen.bmj.com/content/10/9/e037028.full |
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