Skip to main content

Advertisement

SpringerLink
Log in

Magnesium oxide and hip fracture in the elderly: a population-based retrospective cohort analysis

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

Using national insurance claims of Taiwan, we found that magnesium oxide (MgO) use is associated with an increased risk of hip fracture in the elderly. Further studies are warranted to explore the mechanisms associated with MgO use that lead to hip fracture.

Purpose

The purpose of this study was to investigate the association between MgO use and hip fracture risk in the elderly (age > 65 years).

Methods

This nationwide population-based retrospective study was conducted from 1996 to 2013. Individuals with (n = 26,069) and without (n = 26,069) MgO use were enrolled after propensity score matching. Primary outcome was a hip fracture. After adjusting for age, sex, comorbidities, and medications, multivariate Cox proportional hazards regression models were used to calculate incidences and risk of hip fracture [hazard ratio (HR)].

Results

During the mean follow-up duration of 4.8 years in the MgO cohort and 5.7 years in the non-MgO cohort, respectively 1547 and 1107 cases developed a hip fracture. MgO use was identified as a risk factor for hip fracture in both univariate [crude HR, 1.68; 95% confidence interval (CI), 1.55–1.81; p < 0.001] and multivariate [adjusted HR (aHR), 1.66; 95% CI, 1.54–1.80; p < 0.001] Cox proportional hazards regression models. The cumulative incidence of hip fracture was significantly higher in the MgO cohort than in the non-MgO cohort (1.23 per 100 person-years vs. 0.74 per 100 person-years, logrank test, p < 0.001).

Conclusion

MgO use is an independent risk factor for hip fracture in the elderly.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Bentler SE, Liu L, Obrizan M, Cook EA, Wright KB, Geweke JF, Chrischilles EA, Pavlik CE, Wallace RB, Ohsfeldt RL, Jones MP, Rosenthal GE, Wolinsky FD (2009) The aftermath of hip fracture: discharge placement, functional status change, and mortality. Am J Epidemiol 170:1290–1299

    Article  Google Scholar 

  2. Farahmand BY, Michaelsson K, Ahlbom A, Ljunghall S, Baron JA (2005) Survival after hip fracture. Osteoporos Int 16:1583–1590

    Article  Google Scholar 

  3. Forsen L, Sogaard AJ, Meyer HE, Edna T, Kopjar B (1999) Survival after hip fracture: short- and long-term excess mortality according to age and gender. Osteoporos Int 10:73–78

    Article  CAS  Google Scholar 

  4. Johnell O, Kanis JA (2004) An estimate of the worldwide prevalence, mortality and disability associated with hip fracture. Osteoporos Int 15:897–902

    Article  CAS  Google Scholar 

  5. Wang CB, Lin CF, Liang WM, Cheng CF, Chang YJ, Wu HC, Wu TN, Leu TH (2013) Excess mortality after hip fracture among the elderly in Taiwan: a nationwide population-based cohort study. Bone 56:147–153

    Article  Google Scholar 

  6. Haentjens P, Autier P, Barette M, Venken K, Vanderschueren D, Boonen S (2007) Survival and functional outcome according to hip fracture type: a one-year prospective cohort study in elderly women with an intertrochanteric or femoral neck fracture. Bone 41:958–964

    Article  CAS  Google Scholar 

  7. Braithwaite RS, Col NF, Wong JB (2003) Estimating hip fracture morbidity, mortality and costs. J Am Geriatr Soc 51:364–370

    Article  Google Scholar 

  8. Shyu YI, Chen MC, Liang J, Lu JF, Wu CC, Su JY (2004) Changes in quality of life among elderly patients with hip fracture in Taiwan. Osteoporos Int 15:95–102

    Article  Google Scholar 

  9. Wiktorowicz ME, Goeree R, Papaioannou A, Adachi JD, Papadimitropoulos E (2001) Economic implications of hip fracture: health service use, institutional care and cost in Canada. Osteoporos Int 12:271–278

    Article  CAS  Google Scholar 

  10. Cooper C, Campion G, Melton LJ 3rd (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285–289

    Article  CAS  Google Scholar 

  11. Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7:407–413

    Article  CAS  Google Scholar 

  12. Poly TN, Islam MM, Yang HC, Wu CC, Li YJ (2019) Proton pump inhibitors and risk of hip fracture: a meta-analysis of observational studies. Osteoporos Int 30:103–114

    Article  CAS  Google Scholar 

  13. Corley DA, Kubo A, Zhao W, Quesenberry C (2010) Proton pump inhibitors and histamine-2 receptor antagonists are associated with hip fractures among at-risk patients. Gastroenterology 139:93–101

    Article  Google Scholar 

  14. Cea Soriano L, Ruigomez A, Johansson S, Garcia Rodriguez LA (2014) Study of the association between hip fracture and acid-suppressive drug use in a UK primary care setting. Pharmacotherapy 34:570–581

    Article  CAS  Google Scholar 

  15. Pouwels S, Lalmohamed A, Souverein P, Cooper C, Veldt BJ, Leufkens HG, de Boer A, van Staa T, de Vries F (2011) Use of proton pump inhibitors and risk of hip/femur fracture: a population-based case-control study. Osteoporos Int 22:903–910

    Article  CAS  Google Scholar 

  16. Haring B, Pettinger M, Bea JW, Wactawski-Wende J, Carnahan RM, Ockene JK, Wyler von Ballmoos M, Wallace RB, Wassertheil-Smoller S (2013) Laxative use and incident falls, fractures and change in bone mineral density in postmenopausal women: results from the Women's Health Initiative. BMC Geriatr 13:38

    Article  Google Scholar 

  17. Castiglioni S, Cazzaniga A, Albisetti W, Maier JA (2013) Magnesium and osteoporosis: current state of knowledge and future research directions. Nutrients 5:3022–3033

    Article  CAS  Google Scholar 

  18. Orchard TS, Larson JC, Alghothani N, Bout-Tabaku S, Cauley JA, Chen Z, LaCroix AZ, Wactawski-Wende J, Jackson RD (2014) Magnesium intake, bone mineral density, and fractures: results from the Women's Health Initiative observational study. Am J Clin Nutr 99:926–933

    Article  CAS  Google Scholar 

  19. Farsinejad-Marj M, Saneei P, Esmaillzadeh A (2016) Dietary magnesium intake, bone mineral density and risk of fracture: a systematic review and meta-analysis. Osteoporos Int 27:1389–1399

    Article  CAS  Google Scholar 

  20. Cheng CL, Chien HC, Lee CH, Lin SJ, Yang YH (2015) Validity of in-hospital mortality data among patients with acute myocardial infarction or stroke in National Health Insurance Research Database in Taiwan. Int J Cardiol 201:96–101

    Article  Google Scholar 

  21. Vestergaard P, Rejnmark L, Mosekilde L (2006) Proton pump inhibitors, histamine H2 receptor antagonists, and other antacid medications and the risk of fracture. Calcif Tissue Int 79:76–83

    Article  CAS  Google Scholar 

  22. Nieves JW (2014) Bone. Maximizing bone health--magnesium, BMD and fractures. Nat Rev Endocrinol 10:255–256

    Article  CAS  Google Scholar 

  23. Blumenthal NC, Betts F, Posner AS (1977) Stabilization of amorphous calcium phosphate by mg and ATP. Calcif Tissue Res 23:245–250

    Article  CAS  Google Scholar 

  24. Veronese N, Stubbs B, Solmi M, Noale M, Vaona A, Demurtas J, Maggi S (2017) Dietary magnesium intake and fracture risk: data from a large prospective study. Br J Nutr 117:1570–1576

    Article  CAS  Google Scholar 

  25. Pinheiro MM, Schuch NJ, Genaro PS, Ciconelli RM, Ferraz MB, Martini LA (2009) Nutrient intakes related to osteoporotic fractures in men and women--the Brazilian osteoporosis study (BRAZOS). Nutr J 8:6

    Article  Google Scholar 

  26. Shangraw RF (1989) Factors to consider in the selection of a calcium supplement. Public Health Rep 104(Suppl):46–50

    PubMed  PubMed Central  Google Scholar 

  27. Bo-Linn GW, Davis GR, Buddrus DJ, Morawski SG, Santa Ana C, Fordtran JS (1984) An evaluation of the importance of gastric acid secretion in the absorption of dietary calcium. J Clin Invest 73:640–647

    Article  CAS  Google Scholar 

  28. Bandali E, Wang Y, Lan Y, Rogers MA, Shapses SA (2018) The influence of dietary fat and intestinal pH on calcium bioaccessibility: an in vitro study. Food Funct 9:1809–1815

    Article  CAS  Google Scholar 

  29. Kim KM, Choi SH, Lim S, Moon JH, Kim JH, Kim SW, Jang HC, Shin CS (2014) Interactions between dietary calcium intake and bone mineral density or bone geometry in a low calcium intake population (KNHANES IV 2008-2010). J Clin Endocrinol Metab 99:2409–2417

    Article  CAS  Google Scholar 

  30. Hansen KE, Nieves JW, Nudurupati S, Metz DC, Perez MC (2019) Dexlansoprazole and esomeprazole do not affect bone homeostasis in healthy postmenopausal women. Gastroenterology 156:926–934.e926

  31. Friedman AW (2006) Important determinants of bone strength: beyond bone mineral density. J Clin Rheumatol 12:70–77

    Article  Google Scholar 

  32. Ammann P, Rizzoli R (2003) Bone strength and its determinants. Osteoporos Int 14(Suppl 3):S13–S18

    Article  Google Scholar 

  33. Jung SB, Nagaraja V, Kapur A, Eslick GD (2015) Association between vitamin B12 deficiency and long-term use of acid-lowering agents: a systematic review and meta-analysis. Intern Med J 45:409–416

    Article  CAS  Google Scholar 

  34. Festen HP (1991) Intrinsic factor secretion and cobalamin absorption. Physiology and pathophysiology in the gastrointestinal tract. Scand J Gastroenterol Suppl 188:1–7

    Article  CAS  Google Scholar 

  35. Green R, Allen LH, Bjorke-Monsen AL et al (2017) Vitamin B12 deficiency. Nat Rev Dis Primers 3:17040

    Article  Google Scholar 

  36. Herrmann M, Widmann T, Herrmann W (2005) Homocysteine--a newly recognised risk factor for osteoporosis. Clin Chem Lab Med 43:1111–1117

    CAS  PubMed  Google Scholar 

  37. Lewis JR, Barre D, Zhu K, Ivey KL, Lim EM, Hughes J, Prince RL (2014) Long-term proton pump inhibitor therapy and falls and fractures in elderly women: a prospective cohort study. J Bone Miner Res 29:2489–2497

    Article  Google Scholar 

  38. Stabler SP (2013) Vitamin B12 deficiency. N Engl J Med 368:2041–2042

    Article  CAS  Google Scholar 

  39. Thong BKS, Ima-Nirwana S, Chin KY (2019) Proton pump inhibitors and fracture risk: a review of current evidence and mechanisms involved. Int J Environ Res Public Health 16

  40. New SA (1999) Bone health: the role of micronutrients. Br Med Bull 55:619–633

    Article  CAS  Google Scholar 

  41. Nieves JW (2005) Osteoporosis: the role of micronutrients. Am J Clin Nutr 81:1232s-1239s

Download references

Funding

This work was supported by grants from the Ministry of Health and Welfare, Taiwan (MOHW108-TDU-B-212-133004), China Medical University Hospital, Academia Sinica Stroke Biosignature Project (BM10701010021), MOST Clinical Trial Consortium for Stroke (MOST 108-2321-B-039-003-), Tseng-Lien Lin Foundation, Taichung, Taiwan, and Katsuzo and Kiyo Aoshima Memorial Funds, Japan.

Author information

Authors and Affiliations

  1. Department of Psychiatry, Buddhist Tzu Chi General Hospital, Hualien, Taiwan

    Y.Y. Wu

  2. Management office for Health Data, China Medical University Hospital, Taichung, Taiwan

    C.L. Chang

  3. College of Medicine, China Medical University, Taichung, Taiwan

    C.L. Chang

  4. Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan

    J.H. Wang

  5. Department of Emergency Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan

    W.T. Wei

Authors
  1. Y.Y. Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C.L. Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J.H. Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. W.T. Wei
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to W.T. Wei.

Ethics declarations

This study was approved by the ethics review board of China Medical University (CMUH-104-REC2–115).

Conflict of interest

Ying-Ying Wu, Chia-Ling Chang, Jen-Hung Wang, and Wei-Ting Wei declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Animal studies

This article does not describe any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wu, Y., Chang, C., Wang, J. et al. Magnesium oxide and hip fracture in the elderly: a population-based retrospective cohort analysis. Osteoporos Int 31, 1231–1238 (2020). https://doi.org/10.1007/s00198-020-05278-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-020-05278-3

Keywords

Search

Navigation