Journal of Bone and Mineral Metabolism

, Volume 36, Issue 6, pp 741–748 | Cite as

Increased risk of fractures in patients with polycystic ovary syndrome: a nationwide population-based retrospective cohort study

  • Hsin-Yi Yang
  • Herng-Sheng Lee
  • Wan-Ting Huang
  • Ming-Jer Chen
  • Solomon Chih-Cheng Chen
  • Yueh-Han HsuEmail author
Original Article


Polycystic ovary syndrome (PCOS) is a complex disorder; various features of this disorder may influence bone metabolism and skeletal mass. The contribution of PCOS to lower bone mineral density has been recognized. However, the impact of PCOS on the long-term risks for fractures remains inconclusive. The aim of this study was to determine the risk of overall fracture and fractures at different anatomic sites in patients with PCOS. Using a nationwide health insurance claims database, we included 11,106 subjects, aged 15–80 years, with newly diagnosed PCOS (ICD-9-CM: 254.4X) during 2000–2012. Patients with PCOS and respective age-matched (1:4) controls without PCOS were enrolled. The occurrence of fracture was monitored until the end of 2013. Cox regression and computed hazard ratios (HR) with 95% confidence intervals (95% CI) were used to determine the risk of PCOS among women with fractures. The PCOS and non-PCOS groups were comprised of 11,106 patients with PCOS and 44,424 participants without PCOS, respectively. Patients with PCOS had a higher incidence of any fractures compared with non-PCOS group (10.16 versus 8.07 per 1000 person-years) and a greater risk of any fractures [adjusted hazard ratio (aHR) = 1.23, 95% CI = 1.13–1.33], osteoporotic fractures (aHR = 1.33, 95% CI = 1.15–1.54), spine fractures (aHR = 1.36, 95% CI = 1.11–1.66) and forearm fractures (aHR = 1.39, 95% CI = 1.07–1.80), but the risk for femur or hip fracture, humerus, wrist and non-osteoporotic fractures were not increased. In conclusion, the PCOS group had a higher occurrence rate of fractures than the non-PCOS group. These results provide evidence for the adverse effects of PCOS on the risk of fractures.


Fracture Polycystic ovary syndrome Taiwan National Health Insurance Research Database 



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.

Compliance with ethical standards

Conflict of interest

The authors disclose no conflicts of financial or other interest.


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Copyright information

© The Japanese Society for Bone and Mineral Research and Springer Japan KK, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Clinical Medicine Research CenterDitmanson Medical Foundation Chia-Yi Christian HospitalChia-YiTaiwan
  2. 2.Department of Pathology and Laboratory MedicineKaohsiung Veterans General HospitalKaohsiungTaiwan
  3. 3.Department of Obstetrics and Gynecology and Women’s HealthTaichung Veterans General HospitalTaichungTaiwan
  4. 4.Heng Chun Christian HospitalPingtung CountyTaiwan
  5. 5.Department of Pediatrics, School of MedicineTaipei Medical UniversityTaipeiTaiwan
  6. 6.Department of Medical ResearchChina Medical University Hospital and China Medical UniversityTaichungTaiwan
  7. 7.Division of Nephrology, Department of Internal MedicineDitmanson Medical Foundation Chia-Yi Christian HospitalChia-YiTaiwan
  8. 8.Department of NursingMin-Hwei College of Health Care ManagementTainanTaiwan

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