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Article

Low Bone Mineral Density and Calcium Levels as Risks for Mortality in Patients with Self-Discontinuation of Anti-Osteoporosis Medication

by 1,2,3, 1,3,4, 1,5, 2,6,7,8, 5,9, 10, 11 and 2,5,11,12,13,14,*
1
Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung 40705, Taiwan
2
College of Medicine, National Chung Hsing University, Taichung 402202, Taiwan
3
Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan
4
Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
5
School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
6
Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan
7
Cancer Prevention and Control Center, Taichung Veterans General Hospital, Taichung 40705, Taiwan
8
Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, Taichung 40705, Taiwan
9
Department of Orthopedics, Taichung Veterans General Hospital, Taichung 40705, Taiwan
10
Department of Nursing, Taichung Veterans General Hospital, Taichung 40705, Taiwan
11
Department of Medical Research, Taichung Veterans General Hospital, Taichung 40705, Taiwan
12
Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung 40705, Taiwan
13
Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung 402202, Taiwan
14
Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung 402202, Taiwan
*
Author to whom correspondence should be addressed.
Academic Editor: Jimmy T. Efird
Int. J. Environ. Res. Public Health 2022, 19(1), 197; https://doi.org/10.3390/ijerph19010197
Received: 12 November 2021 / Revised: 15 December 2021 / Accepted: 22 December 2021 / Published: 24 December 2021
(This article belongs to the Section Public Health Statistics and Risk Assessment)
Bone mass density (BMD) has been used universally in osteoporosis diagnosis and management. Adherence to anti-osteoporosis medication is related to mortality risk. This study aimed to investigate the relationship between mortality and low BMD of the femoral neck and vertebra among patients self-discontinuing anti-osteoporosis medication. Between June 2016 and June 2018, this single-center retrospective study recruited 596 participants who self-discontinued anti-osteoporosis medication. Patients were categorized into four groups by BMD of the right femoral neck and lumbar spine. Occurrence and causes of mortality were obtained from medical records. Independent risk factors and the five-year survival of various levels of BMD were analyzed by Cox regression and the Kaplan–Meier survival analysis. BMD value and serum calcium level were significantly lower in the mortality group (p < 0.001). Compared to the reference, the adjusted hazard ratio (HR) for all-cause mortality in patients with lower BMD of both the lumbar spine and femoral neck was 3.03. The five-year cumulative survival rate was also significantly lower (25.2%, p < 0.001). A low calcium level was also associated with mortality (HR: 0.87, 95% CI: 0.76–0.99, p = 0.033). In conclusion, lower BMD and calcium levels were associated with higher mortality risk in patients with poor adherence. Hence, patients self-discontinuing anti-osteoporosis medication should be managed accordingly. View Full-Text
Keywords: osteoporosis; bone mineral density; mortality; serum calcium; adherence osteoporosis; bone mineral density; mortality; serum calcium; adherence
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MDPI and ACS Style

Hsu, C.-S.; Chang, S.-T.; Cheng, Y.-Y.; Lee, H.-T.; Chen, C.-H.; Deng, Y.-L.; Hsu, C.-Y.; Chen, Y.-M. Low Bone Mineral Density and Calcium Levels as Risks for Mortality in Patients with Self-Discontinuation of Anti-Osteoporosis Medication. Int. J. Environ. Res. Public Health 2022, 19, 197. https://doi.org/10.3390/ijerph19010197

AMA Style

Hsu C-S, Chang S-T, Cheng Y-Y, Lee H-T, Chen C-H, Deng Y-L, Hsu C-Y, Chen Y-M. Low Bone Mineral Density and Calcium Levels as Risks for Mortality in Patients with Self-Discontinuation of Anti-Osteoporosis Medication. International Journal of Environmental Research and Public Health. 2022; 19(1):197. https://doi.org/10.3390/ijerph19010197

Chicago/Turabian Style

Hsu, Chun-Sheng, Shin-Tsu Chang, Yuan-Yang Cheng, Hsu-Tung Lee, Chih-Hui Chen, Ya-Lian Deng, Chiann-Yi Hsu, and Yi-Ming Chen. 2022. "Low Bone Mineral Density and Calcium Levels as Risks for Mortality in Patients with Self-Discontinuation of Anti-Osteoporosis Medication" International Journal of Environmental Research and Public Health 19, no. 1: 197. https://doi.org/10.3390/ijerph19010197

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