염증성 장질환 환자에서 척추와 대퇴골절 위험성에 대한 국가건강보험 자료 기반 분석

Abstract

Background: This nationwide population-based study sought to investigate the risk of vertebral and hip fractures in patients with inflammatory bowel diseases (IBD). The risk of vertebral and hip fractures in ulcerative colitis (UC) and Crohn’s disease (CD) patients compared with non-IBD reference population. It also assessed whether the use of steroids affected the risk of vertebral and hip fractures in IBD patients.

Method: Using data from the Korean National Health Insurance claims database between the years 2007-2016, incidence rate ratio (IRR), and the adjusted hazard ratio (aHR) of both vertebral and hip fractures in patients with newly diagnosed IBD and compared with 5-year age- and sex- matched subjects at a matching ratio 1:10 (n=186,871).

Results: The incidence rate and IRR of vertebral and hip fractures in patients with IBD were 2.88/1000 person-years. The risk for vertebral and hip fracture was significantly higher in CD (IRR 1.56, 95% CI, 1.19- 2.04), whereas the risk was not significantly higher in UC patients (IRR 1.16, 95% CI, 1.00- 1.36) compared to matched controls. The use of steroids increased the risk of vertebral and hip fractures. In multivariable analysis, the risk of vertebral and hip fracture increased with age (p trend <-.001).

Conclusions: The risk for vertebral and hip fracture increased in IBD patients compared with non-IBD reference population. Particularly, although the UC patients were older and there was a higher percentage of women, the CD patients had a higher fracture risk regardless of their steroid use.