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The Risk of Developing Osteoporosis in Hemolytic Anemia—What Aggravates the Bone Loss?
- Source :
- Journal of Clinical Medicine, Volume 10, Issue 15, Journal of Clinical Medicine, Vol 10, Iss 3364, p 3364 (2021)
- Publication Year :
- 2021
- Publisher :
- Multidisciplinary Digital Publishing Institute, 2021.
-
Abstract
- Hemolytic anemia (HA) renders erythropoietic stress on the bone marrow and has been linked to osteoporosis. In this nationwide retrospective cohort study, we examined this correlation by utilizing the Taiwan National Health Insurance Research Database (NHIRD). We identified two cohorts, matching population with and without HA in a 1:4 ratio. A total of 2242 HA patients and 8968 non-HA patients were enrolled. Patients with HA had a significantly higher cumulative incidence (log-rank test p = 0.0073), higher incidence density (5.11 vs. 3.76 per 1000 persons-years), and a 1.31-fold risk of developing osteoporosis than non-HA patients (aHR = 1.31, 95% C.I. 1.04–1.63, p = 0.01). After adjusting for age, sex, and comorbidities, patients with factors including female (aHR = 2.57, 95% C.I. 2.05–3.22, p &lt<br />0.001), age &gt<br />65 (aHR = 9.25, 95% C.I. 7.46–11.50, p &lt<br />0.001), diagnosis of cholelithiasis (aHR = 1.76, 95% C.I. 1.20–2.58, p = 0.003) and peptic ulcer disease (aHR = 1.87, 95% C.I. 1.52–2.29, p &lt<br />0.001) had significantly higher risk of osteoporosis. We propose that this correlation may be related to increased hematopoietic stress, increased consumption of nitric oxide (NO) by hemolysis, and the inhibitory effects of iron supplements on osteogenesis through the receptor activator of nuclear factor κB ligand (RANKL)/Osteoprotegerin pathway and the Runt-related transcription factor 2 (RUNX2) factor. Our findings suggest that patients with hemolytic anemia are at a higher risk of developing osteoporosis, and it would be in the patient’s best interest for physicians to be aware of this potential complication and offer preventative measures.
- Subjects :
- 0301 basic medicine
Hemolytic anemia
medicine.medical_specialty
Osteoporosis
Population
Gastroenterology
Article
03 medical and health sciences
0302 clinical medicine
Osteoprotegerin
Internal medicine
medicine
Cumulative incidence
education
hemolytic anemia
education.field_of_study
biology
business.industry
Incidence (epidemiology)
Retrospective cohort study
General Medicine
medicine.disease
osteoporosis
030104 developmental biology
RANKL
hematopoietic stress
030220 oncology & carcinogenesis
biology.protein
Medicine
business
national health insurance research database
Subjects
Details
- Language :
- English
- ISSN :
- 20770383
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Medicine
- Accession number :
- edsair.doi.dedup.....110313335a58ddc477036e41af7dc0a5
- Full Text :
- https://doi.org/10.3390/jcm10153364