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Effect of benign prostatic hyperplasia on the development of spine, hip, and wrist fractures

  • S.C. YangEmail author
  • Y.C. ChiuEmail author
  • P.H. Liu
  • T.J. Hsieh
  • Y.H. Kao
  • Y.K. Tu
Original Article

Abstract

Summary

Benign prostatic hyperplasia is one of the most common diseases in the elderly male population. The urinary tract symptoms may increase the risk of falls and fractures. The results indicated that patients with benign prostatic hyperplasia could increase the risk of vertebral compression fractures in both the thoracic and lumbar spine and also hip fractures, but did not increase the risk of wrist fracture.

Introduction

The relationship between benign prostatic hyperplasia and the development of fall-related fractures, especially vertebral compression fractures, has been seldom mentioned in the literature. This study aimed to evaluate the risk of developing vertebral compression fracture, hip fracture, and wrist fracture in patients with benign prostatic hyperplasia.

Methods

This study obtained claims data retrospectively from the National Health Insurance Research Database of Taiwan and identified 48,114 patients who were diagnosed as having benign prostatic hyperplasia. Subjects of the control cohort were individually matched at a ratio of 4:1 with those in the benign prostatic hyperplasia cohort according to age and the index day. Comorbidities were classified as those existing before the index day and included a previous fracture history, osteoporosis, myocardial infarction, congestive heart failure, diabetes mellitus, hypertension, cerebrovascular accident, etc. The end of the follow-up period of the analyses was the day when the patient developed new vertebral compression fractures, hip fractures, or wrist fractures, terminated enrollment from the National Health Insurance, or died or until the end of 2012. The study used the Cox proportion hazard model to determine the hazard ratio for developing new hip fractures.

Results

Patients with benign prostatic hyperplasia were significantly more likely than those in the control cohort to develop new vertebral compression fractures in the thoracic spine (0.43% vs. 0.40%, adjusted hazard ratio 3.03, confidence interval 2.12–4.31) and lumbar spine (1.26% vs. 1.23%, adjusted hazard ratio 4.12, confidence interval 3.39–5.01), and hip fracture (1.47% vs. 2.09%, adjusted hazard ratio 1.22, confidence interval 1.10–1.36), but does not increase the risk of wrist fracture (0.61% vs. 0.67%, adjusted hazard ratio 1.07, confidence interval 0.85–1.34).

Conclusions

Patients with benign prostatic hyperplasia exhibited an increased risk of developing vertebral compression fractures in both the thoracic and lumbar spine and also hip fractures, but did not increase the risk of wrist fracture. However, more research is needed to confirm this trend in the clinical setting.

Keywords

Benign prostatic hyperplasia National Health Insurance Research Database of Taiwan Vertebral compression fracture 

Notes

Acknowledgements

We would like to thank the Center for Database Research, E-DA Hospital, and Intelligent Medical Big Data Co., Ltd. for data analysis and the Research Database (National Health Insurance Research Database 103-116) by the National Health Insurance.

Funding information

This work was also supported by the Room for Database Research, E-Da Healthcare Group, in the acquisition of data (CFDR-B-104-3-2, CFDR-B-104-3-3, and EDAD 10703).

Compliance with ethical standards

The present study was exempt from full review by the local ethics review committee (IRB No. EMRP-101-027).

Conflicts of interest

None.

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2019

Authors and Affiliations

  1. 1.Department of Orthopedic SurgeryE-Da Hospital / I-Shou UniversityKaohsiung CityPeople’s Republic of China
  2. 2.Department of Orthopedic SurgeryE-Da HospitalKaohsiung CityPeople’s Republic of China
  3. 3.Department of Biomedical EngineeringI-Shou UniversityKaohsiung CityPeople’s Republic of China

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