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Blindness increases the risk for hip fracture and vertebral fracture but not the risk for distal radius fracture: a longitudinal follow-up study using a national sample cohort

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Abstract

Summary

The risks for hip fracture and vertebral fracture, but not the risk for distal radius fracture, were significantly higher in the blindness group than in the control group with a maximum 12-year follow-up.

Purpose

To evaluate the influence of visual impairment on the risk for osteoporotic fractures at common sites: hip, thoracic/lumbar vertebra, and distal radius.

Methods

This longitudinal follow-up study used a database of a national sample cohort from 2002 to 2013 provided by the Korean National Health Insurance Service. Of a total of 1,125,691 subjects, 3918 patients with visual impairment and age ≥ 50 years were enrolled in a 1:4 ratio; 15,672 control participants were matched for age, sex, income, and region of residence. Stratified Cox proportional-hazards models were used to evaluate the crude and adjusted (for steroid medication, rheumatoid arthritis, depression, osteoporosis, diabetes mellitus, and stroke history) hazard ratios (HRs) for each fracture site. Fracture diagnoses were based on the ICD-10 codes: hip fracture (S720, S721, S722), vertebral fracture (S220, S320), and distal radius fracture (S525).

Results

The HRs for hip and vertebral fracture were significantly higher in the blindness group (adjusted HR = 2.46, p < 0.001 for hip fracture; adjusted HR = 1.42, p = 0.020 for thoracic/lumbar vertebral fracture) than in the matched control group. However, the HR for distal radius fracture was not higher in the blindness group. The HRs for all three fracture sites were not significantly higher in the non-blindness visual impairment group after adjustment.

Conclusion

The risks for hip fracture and vertebral fracture were significantly higher in the blindness group. However, the risk for distal radius fracture was not related to visual impairment including blindness.

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Funding

This work was supported in part by a research grant (NRF-2015R1D1A1A01060860 and NRF-2017R1D1A1B03031577) from the National Research Foundation (NRF) of Korea.

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea

    H.G. Choi & B. Park

  2. Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Republic of Korea

    H.G. Choi

  3. Department of Orthopaedic Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea

    J.K. Lee

  4. Department of Ophthalmology, Hallym University College of Medicine, Anyang, Republic of Korea

    M.J. Lee

  5. Department of Statistics and Institute of Statistics, Hallym University, 1 Hallymdaehak-gil, Chuncheon-si, Gangwon-do, 24252, Republic of Korea

    S. Sim

  6. Department of Cornea, External Disease & Refractive Surgery, HanGil Eye Hospital, Catholic Kwandong University College of Medicine, 35 Bupyeong-daero, Bupyeong-gu, Incheon, 21388, Republic of Korea

    S.-M. Lee

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  1. H.G. Choi
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Correspondence to S. Sim or S.-M. Lee.

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Conflict of interest

Hyo Geun Choi and Sang-Mok Lee reported grants from the National Research Foundation (NRF) of Korea during the conduct of the study. Hyo Geun Choi, Joon Kyu Lee, Min Joung Lee, Bumjung Park, Songyong Sim, and Sang-Mok Lee declare that they have no conflict of interest.

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Dr. Sim is responsible for the design of the statistical analysis and that Dr. Lee is responsible for the clinical interpretation and preparation of the manuscript

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Choi, H., Lee, J., Lee, M. et al. Blindness increases the risk for hip fracture and vertebral fracture but not the risk for distal radius fracture: a longitudinal follow-up study using a national sample cohort. Osteoporos Int 31, 2345–2354 (2020). https://doi.org/10.1007/s00198-020-05475-0

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