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Fracture risk and impact of osteoporosis in patients with Parkinson’s disease: a nationwide database study

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Journal of Bone and Mineral Metabolism Aims and scope Submit manuscript

Abstract

Introduction

Patients with Parkinson’s disease (PD) showed an increased risk of fractures in previous studies and a high prevalence of osteoporosis is reportedly a potential contributor. We conducted a nationwide database study on the risk of fractures and the impact of osteoporosis on patients with PD compared to controls.

Materials and methods

Using a nationwide database in South Korea, we identified incident patients with PD in 2004–2006 and selected four age- and sex-matched controls. We checked the occurrence rates of overall and hip fractures and plotted Kaplan–Meier curves and a Cox proportional hazards model to determine risk. We also conducted stratified analyses according to the presence or absence of osteoporosis.

Results

We identified 9126 patients with PD and 35,601 controls. Patients with PD had a greater probability of fractures throughout the study period in Kaplan–Meier curves, and an increased risk of overall (aHR 1.35, 95% CI 1.297–1.405) and hip (aHR 1.814, 95% CI 1.66–1.983) fractures in a Cox proportional hazards model. In the stratified analysis, the increased risk of overall fracture (aHR 1.333, 95% CI 1.273–1.396 and aHR 1.412, 95% CI 1.301–1.532, respectively) and hip fracture (aHR 1.773, 95% CI 1.604–1.96 and aHR 2.008, 95% CI 1.657–2.434, respectively) due to PD was similar between patients with and without osteoporosis.

Discussion

Patients with PD, with or without osteoporosis, are more likely to experience fractures, especially hip fractures. There seems to be no interaction between PD and osteoporosis in regard to the occurrence of fractures, and therefore no effect modification by osteoporosis.

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Data availability

All data used in this study can be obtained through formal application to the National Health Insurance Sharing Service (https://nhiss.nhis.or.kr/bd/ab/bdaba000eng.do).

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Funding

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Author notes

  1. Tae-lim Kim and Seong Jun Byun contributed equally to this work.

Authors and Affiliations

  1. Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea

    Tae-lim Kim, Min Yong Seong, Byung-Mo Oh & Han Gil Seo

  2. Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Songnam, Republic of Korea

    Seong Jun Byun & Sang Jun Park

  3. National Traffic Injury Rehabilitation Hospital, Yangpyeong, Gyeonggi-do, Republic of Korea

    Byung-Mo Oh

  4. Institute of Aging, Seoul National University, Seoul, Republic of Korea

    Byung-Mo Oh

  5. Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea

    Byung-Mo Oh

Authors
  1. Tae-lim Kim
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  2. Seong Jun Byun
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  5. Sang Jun Park
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Contributions

SJB, B-MO, SJP, and HGS designed the experiments. SJB and MYS conducted the experiments. SJB, MYS, and HGS analyzed the data. T-lK, MYS, and HGS prepared the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Sang Jun Park or Han Gil Seo.

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All authors declare that they have no conflict of interest.

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This study was assessed and exempted from review by the institutional review board of Seoul National University Hospital (E-1810-033-977).

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Kim, Tl., Byun, S.J., Seong, M.Y. et al. Fracture risk and impact of osteoporosis in patients with Parkinson’s disease: a nationwide database study. J Bone Miner Metab 40, 602–612 (2022). https://doi.org/10.1007/s00774-022-01322-w

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  • DOI: https://doi.org/10.1007/s00774-022-01322-w

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