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Poster presentations: Epidemiology 2020

P803 The risk of spine and hip fracture in patients with inflammatory bowel diseases: a nationwide population-based study

Y.J. Kim1, H.J. Ahn2, S. Noh3, J.C. Park3, J.Y. Kim3, J. Kim3, N.S. Ham3, E.H. Oh3, S.W. Hwang3, D.H. Yang3, B.D. Ye3, J.S. Byeon3, S.J. Myung3, S.K. Yang3, S.H. Park3

1Asan Medical Center, Clinical Epidemiology and Biostatistics, Seoul, Republic of Korea, 2Asan Medical Center, Internal Medicine, Seoul, Republic of Korea, 3Asan Medical Center, University of Ulsan College of Medicine, Gastroenterology, Seoul, Republic of Korea

Background

This nationwide population-based study sought to investigate the risk of spine and hip fracture in patients with inflammatory bowel diseases (IBD).

Methods

Using the 2007–2016 data from the Korean national health insurance claims database, we calculated incidence rate and incidence rate ratios (IRR) of spine and hip fracture in patients with IBD (n = 18,228; 64.1% male, 65.9% ulcerative colitis [UC]) compared with age- and sex- frequency matched subjects in 1:10 ratio (n = 186,871). A Cox regression model was used to evaluate risk of spine and hip fracture.

Results

The incidence rate and IRR of spine and hip fracture in IBD were 2.88/1000 person-years and 1.21 (95% confidence interval [CI], 1.11–1.31) during the median follow-up of 4.5 years. The risk for spine and hip fracture was significantly higher in UC (IRR 1.39, 95% CI, 1.25- 1.54), whereas it was not significantly higher in Crohn’s disease (IRR 0.85, 95% CI, 0.67- 1.06) than matched controls. In UC, the IRR of spine fracture was 1.41 (95% CI, 1.24–1.58) and the IRR of hip fracture was 1.40 (95% CI, 1.11–1.71). In multivariable analysis using the Cox regression model, the risk of spine and hip fracture increased with age (p trend < 0.001), in female patients (adjusted hazard ratio [aHR], 1.94; 95% CI, 1.50–2.51) and in patients with comorbidities including osteoporosis (aHR 2.86; 95% CI, 2.10–3.89), stroke (aHR 2.74; 95% CI, 1.78–4.21) hypertension (aHR 1.82; 95% CI, 1.38–2.41), diabetes mellitus (aHR 1.67; 95% CI, 1.25–2.24) and dyslipidaemia (aHR 1.36; 95% CI, 1.05–1.78).

Conclusion

In a population-based study from Korea, we found that the risk for spine and hip fracture increased in patients with IBD, especially in UC patients. Also, this risk increased in patients who are older, female, or have comorbidities.