Osteoporosis and the long-term risk of peripheral artery disease: a population-based longitudinal follow-up study in Taiwan.

INTRODUCTION: Osteoporosis has been linked to atherosclerotic diseases such as coronary heart disease and ischemic stroke. However, the relationship between osteoporosis and peripheral artery disease (PAD) has not been investigated. This study aims to evaluate the risk of PAD in patients with osteoporosis and the impact of sex on this association. METHODS: This population-based study used the Longitudinal Health Insurance Database 2005, a subset of Taiwan's National Health Insurance research database. A total of 54,324 individuals between 40 and 79 years old were included in this study. The osteoporosis group (n = 27,162) consisted of patients with a diagnosis of osteoporosis between January 1, 2002, and December 31, 2006, while the non-osteoporosis group were patients without osteoporosis selected by stratified random sampling (n = 27,162). The primary outcome was the occurrence of newly diagnosed PAD. Cox proportional hazard regression modeling was used to evaluate the association between osteoporosis and the risk of PAD, with adjustment for the baseline characteristics. RESULTS: The risk of PAD for the osteoporosis group was 28% higher than for the non-osteoporosis group (adjusted hazard ratio (HR) 1.28, 95% confidence interval [CI] 1.20-1.36, p < 0.001), and the PAD-free survival rate was lower in the osteoporosis group (p < 0.001). Sex-stratified analysis revealed a similar HR magnitude between osteoporotic men (HR 1.36; 95% CI 1.19-1.57) and women (HR 1.25; 95% CI 1.17-1.35), compared with their non-osteoporotic counterparts. CONCLUSION: This study found an increased long-term risk of PAD in both men and women with osteoporosis. Osteoporosis has been associated with increased risks of atherosclerotic diseases. However, the relationship between osteoporosis and peripheral artery disease remains uncertain. The present population-based longitudinal follow-up study showed that patients with osteoporosis are at an increased risk of developing peripheral artery disease.