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ORIGINAL ARTICLE
Year : 2018  |  Volume : 29  |  Issue : 3  |  Page : 145-150

Urolithiasis is associated with the increased risk for osteoporosis: A nationwide 9-year follow-up study


1 Department of Urology, Kaohsiung Medical University Hospital; Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
2 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
3 Department of Urology, Kaohsiung Medical University Hospital; Department of Urology, Kaohsiung Municipal Ta-Tung Hospital; Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
4 Department of Urology, Kaohsiung Medical University Hospital; Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
5 Department of Urology, Kaohsiung Medical University Hospital; Department of Urology, Kaohsiung Municipal Siaogang Hospital; Department of Urology, Kaohsiung Municipal Ta-Tung Hospital; Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
6 Department of Urology, Kaohsiung Medical University Hospital; Department of Urology, Kaohsiung Municipal Siaogang Hospital; Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

Correspondence Address:
Tsu-Ming Chien
Department of Urology, Kaohsiung Medical University, Hospital, Hospital No. 100, Tz-You 1st Road, Kaohsiung 807
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/UROS.UROS_20_17

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Objective: We aimed to determine whether urolithiasis is a warning sign indicating long-term osteoporosis. Controls were matched for age, sex, and other comorbidities, including hypertension, diabetes mellitus, dyslipidemia, liver disease, and cardiovascular disease. Materials and Methods: Data were obtained from the Longitudinal Health Insurance Database (LHID2000) of Taiwan, Republic of China, compiled by the NHI from 1996 to 2013. We further evaluated potential risk factors stratified by different comorbidities. Results: After performing the propensity score matching (urolithiasis: control; ratio, 1:3), we included a total of 104,900 patients, including 26,225 patients with urolithiasis and 78,675 control patients. There was a significant difference between the incidence of osteoporosis between the urolithiasis and control groups (adjusted hazard ratio 1.20, 95% confidence interval [CI]: 1.15–1.27, P < 0.001). Interestingly, the impact of urolithiasis on osteoporosis was more prominent in the younger patient population (age < 40 years, adjusted hazard ratio 1.4, 95% CI: 1.12–1.75, P = 0.003; 40–59 years, adjusted hazard ratio 1.3, 95% CI: 1.20–1.40, P < 0.001), than in the older patient population (age >60 years, adjusted hazard ratio 1.13, 95% CI: 1.05–1.21, P = 0.001; P = 0.015 for interaction). We also observed that urolithiasis had an impact on hypertension-free patients (hypertension free, adjusted hazard ratio 1.28, 95% CI: 1.20–1.36, P < 0.001; hypertension, adjusted hazard ratio 1.12, 95% CI: 1.03–1.22, P = 0.006, P = 0.020 for interaction). Conclusion: In conclusion, on the basis of our results, an association exists between urolithiasis patients and subsequent osteoporosis diagnosis. Although the clinical mechanisms are not fully understood, patients who had urolithiasis history may need regular follow-up of bone marrow density.


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