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Psoriasis is associated with an increased risk of osteoporosis: follow-up and nested case–control studies using a national sample cohort

Osteoporosis International volume 32, pages 529–538 (2021)Cite this article

Abstract

Summary

A total of 25,306 psoriasis participants were matched to 101,224 controls, and the occurrence of osteoporosis was analyzed. Additionally, 79,212 osteoporosis patients were matched to 79,212 controls and a previous history of psoriasis was analyzed. Psoriasis increased the risk of osteoporosis among participants aged ≥ 40 years.

Introduction

The aim of the present study was to evaluate the association between psoriasis and osteoporosis using two different studies.

Methods

Data from the Korean National Health Insurance Service-Health Screening Cohort of participants aged ≥ 40 years were collected from 2002 to 2013. Psoriasis and osteoporosis were included using International Classification of Diseases (ICD)-10 codes. In study I (a follow-up study), a total of 25,306 psoriasis participants were matched to 101,224 controls with respect to age, sex, income, and region of residence, and the occurrence of osteoporosis was analyzed. Crude (simple) and adjusted hazard ratios (HRs) were analyzed using a stratified Cox proportional hazard model. In study II (a nested case–control study), a total of 79,212 osteoporosis patients were matched to 79,212 controls and a previous history of psoriasis was analyzed. Crude and adjusted odds ratios (ORs) were analyzed using a conditional logistic regression analysis. Subgroup analyses were conducted according to age group and sex.

Results

The adjusted HR of osteoporosis was 1.09 (95% confidence interval [CI] = 1.05–1.13, P < 0.001) in study I. In the subgroup analysis according to age and sex, the results were consistent except for ≥ 60-year-old women. The adjusted OR of psoriasis was 1.21 (95% CI = 1.16–1.27, P < 0.001) in study II. All subgroups demonstrated high adjusted ORs of osteoporosis for psoriasis.

Conclusions

Psoriasis increased the risk of osteoporosis among participants aged ≥ 40 years in Korea.

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Data availability

Distribution of the data by the researcher is not legally allowed. All the data are available from the National Health Insurance Sharing Service (NHISS) database (https://nhiss.nhis.or.kr/). The NHISS allows access to all the data to any researcher who promises to follow research ethics standards for a fee. If you want to access the data of this article, you can download them from the website after agreeing to follow research ethics standards.

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Acknowledgments

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 (A542-1377-62EB-072D-B30P).

Funding

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

Author information

Affiliations

  1. Department of Orthopaedic Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea

    J.W. Lee

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

    C. Min & H.G. Choi

  3. Graduate School of Public Health, Seoul National University, Seoul, Korea

    C. Min

  4. Department of Dermatology, Seoul St Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul, South Korea

    C.H. Bang

  5. Department of Orthopedic Surgery, Hallym University College of Medicine, Anyang, Korea

    B.C. Kwon

  6. Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 22, Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do, 14068, Republic of Korea

    H.G. Choi

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  1. J.W. Lee
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  5. H.G. Choi
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Correspondence to H.G. Choi.

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Lee, J., Min, C., Bang, C. et al. Psoriasis is associated with an increased risk of osteoporosis: follow-up and nested case–control studies using a national sample cohort. Osteoporos Int 32, 529–538 (2021). https://doi.org/10.1007/s00198-020-05724-2

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  • DOI: https://doi.org/10.1007/s00198-020-05724-2

Keywords

  • Case–control studies
  • Cohort studies
  • Osteoporosis
  • Psoriasis
  • Risk factors