Incidence of Osteopenia or Osteoporosis in Asian Patients With Chronic Hepatitis B
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Updated: May 9, 2025
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Published on: December 15, 2023
Hye Won Lee1,2,3, Sungshin Kwon4, Yeo Rae Moon5
1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Insights
Patients with chronic hepatitis B (CHB) and those without CHB showed similar risks for osteopenia or osteoporosis. Further research is needed to understand bone health factors in CHB patients.
Area of Science:
- Gerontology
- Hepatology
- Endocrinology
Background:
- Aging populations increase the risk of osteopenia, osteoporosis, and fractures in patients with chronic hepatitis B (CHB).
- Investigating the epidemiology and risk factors for bone disease in CHB patients is crucial.
Purpose of the Study:
- To investigate the epidemiology and risk factors for osteopenia or osteoporosis in patients with chronic hepatitis B (CHB).
Main Methods:
- Retrospective cohort study of patients aged 19+ with at least two bone mineral density (BMD) tests between 2005 and 2021.
- Matched 275 CHB patients with 7868 non-CHB patients (1:4 ratio) using propensity scores.
- Cox proportional hazard regression models assessed osteopenia or osteoporosis risk.
Main Results:
- Incidence of osteopenia or osteoporosis was 25.8% in CHB patients and 28.7% in non-CHB patients.
- After matching, no significant differences in cumulative hazard for bone disease were found between groups.
- Identified risk factors for osteopenia/osteoporosis: older age, BMI < 25, chronic kidney disease, and proton pump inhibitor use.
Conclusions:
- Patients with or without CHB exhibit comparable risks for osteopenia and osteoporosis.
- Closer monitoring for bone disease is recommended for CHB patients with higher risk factors.
- Further research into bone disease in CHB patients is warranted to understand factors impacting bone health.
Background:
In an aging population, patients with chronic hepatitis B (CHB) may face a higher risk of osteopenia, osteoporosis, or fractures. We investigated the epidemiology and risk factors associated with osteopenia or osteoporosis in patients with CHB.
Methods:
This retrospective cohort study included patients ≥ 19 years who underwent bone mineral density (BMD) testing ≥ 2 times between 2005 and 2021 at Severance Hospital, Seoul, South Korea. Demographic factors and comorbidities for patients with or without CHB were matched based on a 1:4 ratio. Cox proportional hazard regression models were used to estimate hazard ratios to assess osteopenia or osteoporosis risk.
Results:
A total of 275 patients with CHB and 7868 patients without CHB who had normal BMD were analyzed. The incidence of osteopenia or osteoporosis in patients with and without CHB was 25.8% and 28.7%, respectively. After propensity score matching, in the second BMD test, 73.8%, 24.7%, and 1.5% of patients with CHB and 70.7%, 26.5%, and 2.8% of patients without CHB had normal BMD, osteopenia, and osteoporosis, respectively. Risk factors for osteopenia or osteoporosis in these patients were age, body mass index < 25, chronic kidney disease, and proton pump inhibitor use. There were no significant differences in cumulative hazard for patients with or without CHB.
Conclusions:
Patients with or without CHB showed similar risks of osteopenia or osteoporosis. In addition to providing closer monitoring for patients with CHB with greater bone disease risk, further studies of bone disease in these patients may help to understand the factors that impact bone health.
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