Effect of comorbidities and multimorbidity on bone mineral density in patients with osteoporosis

IF 2.8 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Archives of Osteoporosis Pub Date : 2025-09-08 DOI:10.1007/s11657-025-01604-6

Luis Leal-Vega, María Begoña Coco-Martín, Adrián Martín-Gutiérrez, José Antonio Blázquez-Cabrera, Francisca Arranz-García, Amalia Navarro, María Jesús Moro, José Filgueira, Manuel Sosa-Henríquez, María Ángeles Vázquez, María José Montoya, Manuel Díaz-Curiel, José Manuel Olmos, José Luis Pérez-Castrillón, OSTEOMED Group

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引用次数: 0

Abstract

Summary

This retrospective cohort study analysed a total of 344 patients from the OSTEOMED registry with matched baseline and follow-up DXA data, finding that comorbidities such as nephrolithiasis, hypertension or coronary heart disease may influence the response to prescribed anti-osteoporotic treatment.

Purpose

To determine: 1) comorbidities associated with reduced bone mineral density (BMD), T-score and Z-score at the lumbar spine (L1 to L4 vertebrae), femoral neck and total hip; and 2) the role of multimorbidity (≥ 2 comorbidities) in reduced BMD, T-score and Z-score at the lumbar spine, femoral neck and total hip.

Methods

Retrospective cohort study analyzing patients [319 females (92.73%), 25 males (7.27%), age 62.13 ± 10.46 years] from the OSTEOMED registry with matched baseline and follow-up dual-energy X-ray absorptiometry (DXA) data. Patients' sex, age, body mass index (BMI), comorbidities and treatments were collected from their medical records after they had given written informed consent.

Results

Considering a least significant change (LSC) of 4.2%, neither comorbidity nor multimorbidity was statistically significantly associated with a reduction in BMD in any of the bone regions studied. However, binary logistic regression analyses adjusted for sex, age, BMI and treatments showed that nephrolithiasis (p = 0.044) and coronary heart disease (p = 0.026) were statistically significantly associated with a reduction in total hip T-score and that hypertension (p = 0.049) and coronary heart disease (p = 0.01) were statistically significantly associated with a reduction in total hip Z-score.

Conclusion

Despite comorbidity and multimorbidity, patients with osteoporosis are mostly well protected by anti-osteoporotic treatment in daily clinical practice. However, nephrolithiasis, hypertension, and coronary heart disease can influence the response to prescribed anti-osteoporotic treatment, especially at the total hip level.

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合并症和多病对骨质疏松症患者骨密度的影响

这项回顾性队列研究分析了来自OSTEOMED登记的344例患者，这些患者具有匹配的基线和随访DXA数据，发现肾结石、高血压或冠心病等合并症可能影响处方抗骨质疏松治疗的反应。目的确定：1)腰椎（L1至L4椎体）、股骨颈和全髋关节骨密度（BMD）、t评分和z评分降低相关的合并症；2)多病（≥2个合并症）在腰椎、股骨颈和全髋关节的BMD、t评分和z评分降低中的作用。方法回顾性队列研究分析来自OSTEOMED注册的患者[319名女性（92.73%），25名男性（7.27%），年龄62.13±10.46岁]，具有匹配的基线和随访双能x线吸收仪（DXA）数据。在患者给予书面知情同意后，从其医疗记录中收集患者的性别、年龄、体重指数（BMI）、合并症和治疗情况。考虑到最小显著变化（LSC）为4.2%，在研究的任何骨骼区域，合并症和多病均与骨密度降低没有统计学上的显著相关性。然而，经性别、年龄、BMI和治疗调整后的二元logistic回归分析显示，肾结石（p = 0.044）和冠心病（p = 0.026）与髋部总t评分降低有统计学显著相关，高血压（p = 0.049）和冠心病（p = 0.01）与髋部总z评分降低有统计学显著相关。结论尽管骨质疏松患者存在合并症和多病性，但在日常临床实践中，抗骨质疏松治疗对骨质疏松患者大多有较好的保护作用。然而，肾结石、高血压和冠心病可影响处方抗骨质疏松治疗的反应，特别是在全髋关节水平。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Osteoporosis ENDOCRINOLOGY & METABOLISMORTHOPEDICS -ORTHOPEDICS

CiteScore

5.50

自引率

10.00%

发文量

133

期刊介绍： Archives of Osteoporosis is an international multidisciplinary journal which is a joint initiative of the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA. The journal will highlight the specificities of different regions around the world concerning epidemiology, reference values for bone density and bone metabolism, as well as clinical aspects of osteoporosis and other bone diseases.