Impact of anti-osteoporotic treatments on hyperlipidemia risk in osteoporosis patients: evidence from a population-based retrospective cohort study

Abstract

Background: In this population-based retrospective cohort study, we investigated the relationship between osteoporosis and the risk of hyperlipidemia, the main risk factor for cardiovascular disease (CVD). Despite extensive research on both conditions, the association between osteoporosis and hyperlipidemia remains unclear, particularly in Asian populations.

Methods: Using information from Taiwan's Longitudinal Generation Tracking Database, we conducted a retrospective population-based cohort study spanning 2000-2021. Patients in the comparison cohort were chosen at random and frequency-matched in a 1:1 ratio based on age, sex, month, and year of the index date. Both cohorts were monitored from the index date until a new diagnosis of hyperlipidemia was established. Data on baseline characteristics, comorbidities, and prescription of anti-osteoporotic treatment (AOTs) were gathered.

Results: The osteoporosis cohort consisted of 67,628 patients aged ≤ 34 years or older, diagnosed with osteoporosis, and without a history of hyperlipidemia. With a mean follow-up of 8.81 years and 9.78 years, respectively, the total incidence of hyperlipidemia was 36.7 (per 1000 person-years) for the osteoporosis cohort and 28.4 for the comparison cohort, after controlling for age, sex, and comorbidities. Without treatment, the hazard ratio (HR) for developing hyperlipidemia was 1.58 (95% confidence interval [CI], 1.54-1.62) for the osteoporosis cohort compared with the comparison cohort. The risk of hyperlipidemia was considerably reduced in patients with osteoporosis who received most types of AOTs [adjusted HR, ≤ 0.31] compared with those who did not receive any of these AOTs.

Conclusion: Our findings suggest a significant association between osteoporosis and increased risk of hyperlipidemia in Asian populations, and highlight the potential protective role of AOTs against hyperlipidemia. These insights could inform clinical strategies to manage patients with osteoporosis and mitigate their risk of CVD.

Keywords: Anti-osteoporotic treatments; Cohort study; Hyperlipidemia; Osteoporosis.

Fig. 1

Cummulative incidence of hyperlipidemia compared between with and without osteoporosis using the Kaplan–Meier method. Case group mean follow-up years 8.81 (SD = 5.93). Control group mean follow-up years 9.78 (SD = 5.96)