Abstract
An association between anemia and an increased risk of osteoporosis has been suggested. The goal of this study was to estimate the association of hemoglobin (Hb) level with osteoporosis. A total of 69,760 osteoporosis patients aged ≥ 40 years old from the Korean National Health Insurance Service Health Screening Cohort were enrolled. From an identical cohort database, 69,760 comparison participants were randomly selected. Hb levels before the onset of osteoporosis were evaluated. The association of Hb level with osteoporosis was analyzed using a conditional logistic regression model adjusted for obesity, smoking status, alcohol consumption, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, and the Charlson comorbidity index score. Fifteen percent of the osteoporosis group and 14.17% of the comparison group had anemia. The Hb level was associated with 0.98-fold lower odds for osteoporosis (95% confidence intervals = 0.97–0.99, p < 0.001). A low Hb level was associated with a high risk of osteoporosis in the adult population. There was a consistent association between a low Hb level and osteoporosis in patients with comorbidities.
Highlights
Osteoporosis is often diagnosed on the basis of low bone mineral density (BMD).In addition to a low body mass index (BMI), an increased risk of fracture is included in the diagnosis of osteoporosis
The Charlson comorbidity index (CCI) scores were different between the osteoporosis and comparison groups (p < 0.001)
Among participants with comorbid conditions, such as obesity, smoking, hypertension, diabetes, and dyslipidemia, there was a consistent association of low Hb levels with osteoporosis
Summary
Osteoporosis is often diagnosed on the basis of low bone mineral density (BMD). In addition to a low body mass index (BMI), an increased risk of fracture is included in the diagnosis of osteoporosis. The prevalence of osteoporosis has been estimated to be approximately 40% in white postmenopausal women [1,2,3,4]. Low BMD is often ignored until fracture or other complications occur. The predictive factors for fracture risk and osteoporosis have been investigated by many researchers. Low BMD has been reported to be associated with aging, low body weight, physical inactivity, smoking, excessive alcohol consumption, diabetes, dyslipidemia, and pernicious anemia [5,6,7]. Chronic iron-deficiency anemia has been suggested to induce bone resorption and increase the risk of osteoporosis [8]
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