Archives of Osteoporosis

, 14:34 | Cite as

The association between hepatitis and osteoporosis: a nested case-control study using a national sample cohort

  • Chanyang Min
  • Woo Jin Bang
  • Miyoung Kim
  • Dong Jun Oh
  • Hyo Geun ChoiEmail author
Original Article



The prevalence of hepatitis B was higher in osteoporosis patients than the control group, especially in females. However, the prevalence of hepatitis C was not different. The matching for various factors improved to have same conditions between osteoporosis patients and the control group.


Although chronic liver disease, including hepatitis B and hepatitis C, has been associated with osteoporosis in previous studies, the evidence was insufficient, and some findings were inconsistent. The aim of this study was to evaluate the relationship between hepatitis B or hepatitis C and osteoporosis.


We used the Korean National Health Insurance Service-National Sample Cohort with ≥ 50-year-old participants from 2002 to 2013. Age was determined at osteoporosis diagnosis. We extracted 68,492 osteoporosis patients (ICD-10 codes E7001–E7004, HC341–HC345) with a 68,492-member control group at a ratio of 1:1 by age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia. We analyzed previous histories of hepatitis B (ICD-10 codes B18.0–B18.1) and hepatitis C (ICD-10 code B18.2) in the osteoporosis patients and control groups. The logistic regression with the crude and adjusted model was analyzed. Additionally, subgroup analyses divided by age and sex were performed.


The adjusted odds ratios for hepatitis B and hepatitis C were 1.19 (95% confidence interval (CI) = 1.11–1.28, P < 0.001) and 1.04 (95% CI = 0.90–1.19, P > 0.05), respectively, in osteoporosis patients. Subgroup analyses showed that the risk of hepatitis B was higher in osteoporosis patients in female groups but not in male groups.


Hepatitis B virus infection might be a risk factor for osteoporosis.


Hepatitis B Hepatitis C Infection Liver disease Osteoporosis Bone loss 



The manuscript was edited for proper English language, grammar, punctuation, spelling, and overall style by the highly qualified native English-speaking editors at American Journal Experts (EF6A-C642-3739-A20A-499P).

Funding information

This work was supported by the Hallym University Research Fund and in part by a research grant (NRF-2018-R1D1A1A02085328) from the National Research Foundation (NRF) of Korea.

Compliance with ethical standards

The Ethics Committee of Hallym University (2014-I148) approved the use of the data from the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC). The Institutional Review Board waived the requirement for written informed consent.

Conflicts of interest


Supplementary material

11657_2019_590_MOESM1_ESM.pdf (186 kb)
ESM 1 (PDF 185 kb)


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2019

Authors and Affiliations

  • Chanyang Min
    • 1
    • 2
    • 3
  • Woo Jin Bang
    • 4
  • Miyoung Kim
    • 5
  • Dong Jun Oh
    • 6
  • Hyo Geun Choi
    • 1
    • 2
    Email author
  1. 1.Hallym Data Science LaboratoryHallym University College of MedicineAnyangSouth Korea
  2. 2.Department of Otorhinolaryngology-Head & Neck SurgeryHallym University College of MedicineAnyangSouth Korea
  3. 3.Graduate School of Public HealthSeoul National UniversitySeoulSouth Korea
  4. 4.Department of UrologyHallym University College of MedicineAnyangSouth Korea
  5. 5.Department of Laboratory MedicineHallym University College of MedicineAnyangSouth Korea
  6. 6.Department of Internal Medicine, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea

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