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Risk of fractures at different anatomic sites in patients with irritable bowel syndrome: a nationwide population-based cohort study

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Abstract

Summary

This study was to investigate the fracture risk of irritable bowel syndrome (IBS) in comparison with non-IBS group. Our results found that IBS group has increased risk for fracture, in particular of the spine, forearm, hip, and hand.

Introduction

Patients with IBS might also be at increased risk of osteoporosis and osteoporotic fractures. Up to now, the association between IBS and the risk of fractures at different anatomic sites occurrences is not completely clear. We conducted a population-based cohort analysis to investigate the fracture risk of IBS in comparison with non-IBS group.

Methods

We identified 29,505 adults aged ≥ 20 years with newly diagnosed IBS using the Taiwan National Health Insurance Research Database in 2000–2012. A comparison group was constructed of patients without IBS who were matched according to gender and age. The occurrence of fracture was monitored until the end of 2013. We analyzed the risk of fracture events to occur in IBS by using Cox proportional hazards regression models.

Results

Patients with IBS had a higher incidence of osteoporotic fractures compared with the non-IBS group (12.34 versus 9.45 per 1000 person-years) and an increased risk of osteoporotic fractures (adjusted hazard ratio [aHR] = 1.27, 95% confidence interval [CI] = 1.20–1.35). Site-specific analysis showed that the IBS group had a higher risk of fractures for spine, forearm, hip, and hand than did the non-IBS group. With further stratification for gender and age, a higher aHR value for osteoporotic fractures in the IBS group was seen across all age groups in males, but seen in elderly females. In addition, female, elderly, low income, hypertension, coronary artery disease, cerebrovascular disease, and depressive disorders as independent osteoporotic fracture risk factors in IBS patients.

Conclusions

The IBS is considered as a risk factor for osteoporotic fractures, particularly in female individuals and fracture sites located at the spine, forearm, hip, and hand.

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Acknowledgements

This study was based in part on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance and the Department of Health and Welfare and managed by the National Health Research Institutes. The interpretation and conclusions contained within do not represent those of the Bureau of National Health Insurance, Department of Health, or National Health Research Institutes.

Author information

Author notes

  1. Herng-Sheng Lee and Chi-Yi Chen contributed equally to this work.

Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, 813, Taiwan

    Herng-Sheng Lee

  2. Department of Internal medicine, Division of Gastroenterology and Hepatology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, 600, Taiwan

    Chi-Yi Chen & Li-Jen Chang

  3. Clinical Medicine Research Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, 600, Taiwan

    Wan-Ting Huang & Hsin-Yi Yang

  4. Heng Chun Christian Hospital, Pingtung County, 946, Taiwan

    Solomon Chih-Cheng Chen

  5. Department of Pediatrics, School of Medicine, Taipei Medical University, Taipei, 110, Taiwan

    Solomon Chih-Cheng Chen

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  1. Herng-Sheng Lee
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Corresponding author

Correspondence to Hsin-Yi Yang.

Ethics declarations

This study was approved by the Institutional Review Board (IRB) of Ditmanson Medical Foundation Chia-Yi Christian Hospital (CYCH-IRB No.2018032), Taiwan, and because the data were obtained from the LHID 2005, informed consent from the participants was not obtained.

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Lee, HS., Chen, CY., Huang, WT. et al. Risk of fractures at different anatomic sites in patients with irritable bowel syndrome: a nationwide population-based cohort study. Arch Osteoporos 13, 80 (2018). https://doi.org/10.1007/s11657-018-0496-7

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