Analysis of Patients with Helicobacter pylori Infection and the Subsequent Risk of Developing Osteoporosis after Eradication Therapy: A Nationwide Population-Based Cohort Study

• Published in: PloS one Vol. 11; no. 9; p. e0162645
• Main Authors: Shih, Hong-Mo, Hsu, Tai-Yi, Chen, Chih-Yu, Lin, Cheng-Li, Kao, Chia-Hung, Chen, Chao-Hsien, Yang, Tse-Yen, Chen, Wei-Kung
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 14.09.2016; Public Library of Science (PLoS)
• Subjects: Aged; Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - therapeutic use; Asthma; Biocompatibility; Biology and Life Sciences; Body mass index; Bone density; Bone Density - drug effects; Bone mineral density; Cardiovascular disease; Case-Control Studies; Cohort analysis; Confidence intervals; Cytokines; Development and progression; Emergency medical care; Epidemiology; Female; Gastric cancer; Gastrointestinal diseases; Gene expression; Health insurance; Health risk assessment; Health risks; Helicobacter infections; Helicobacter Infections - complications; Helicobacter Infections - drug therapy; Helicobacter pylori; Hemodialysis; Homeostasis; Hospitals; Humans; Infection; Infections; Kidney diseases; Male; Medical laboratories; Medical research; Medicine; Medicine and Health Sciences; Middle Aged; National health insurance; Online databases; Osteoporosis; Osteoporosis - chemically induced; Osteoporosis - etiology; Patients; People and Places; Peptic ulcer; Population; Population studies; Population-based studies; Retrospective Studies; Risk Factors; Risk management; Stomach cancer; Studies; Systematic review; Taiwan; Therapy; Ulcers; China; Taiwan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0162645

Previous studies have reported conflicting results on the association between Helicobacter pylori infection and osteoporosis. A few studies have discussed the influence of H. pylori eradication therapy on bone mineral density. We assessed the prevalence of osteoporosis among the H. pylori-infected population in Taiwan and the influence of early and late H. pylori eradication therapy on bone mineral density. Using data from Taiwan's National Health Insurance Research Database, we identified 5,447 patients who received H. pylori eradication therapy from 2000 to 2010 and 21,788 controls, frequency-matched according to age, sex, and year of receiving H. pylori eradication therapy. Those who received H. pylori eradication therapy were divided into two groups based on the time interval between the diagnosis of a peptic ulcer and commencement of eradication therapy. The risk of developing osteoporosis was higher in the early H. pylori treatment cohort (hazard ratio [HR] = 1.52, 95% confidence interval [CI] = 1.23-1.89) and late H. pylori treatment cohort (HR = 1.69, 95% CI = 1.39-2.05), compared with the risk in the control cohort. When followed for less than 5 years, both the early and late cohorts had a higher risk of developing osteoporosis (HR = 1.69, 95% CI = 1.32-2.16 and HR = 1.72, 95% CI = 1.38-2.14). However, when the follow-up period was over 5 years, only the late eradication group exhibited a higher incidence of osteoporosis (HR = 1.62, 95% CI = 1.06-2.47). The development of osteoporosis is complex and multi-factorial. Via this population-based cohort study and adjustment of possible confounding variables, we found H. pylori infection may be associated with an increased risk of developing osteoporosis in Taiwan. Early eradication could reduce the influence of H. pylori infection on osteoporosis when the follow-up period is greater than 5 years. Further prospective studies are necessary to discover the connection of H. pylori and osteoporosis.