Risk factors for fractures following liver transplantation: a population-based cohort study
AbstractBackground Liver transplant recipients have an increased risk of osteoporosis and fractures. The aim of this study was to identify risk factors for fractures after liver transplant in a Taiwanese population.Methods We identified newly diagnosed liver transplant recipients from the National H...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2023.2230871 |
| _version_ | 1797353749888368640 |
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| author | Jei-Wen Chang Hui-Hsin Yang Niang-Cheng Lin Fang-Cheng Kuo Tzu-Ching Lin Hsin-Lin Tsai |
| author_facet | Jei-Wen Chang Hui-Hsin Yang Niang-Cheng Lin Fang-Cheng Kuo Tzu-Ching Lin Hsin-Lin Tsai |
| author_sort | Jei-Wen Chang |
| collection | DOAJ |
| description | AbstractBackground Liver transplant recipients have an increased risk of osteoporosis and fractures. The aim of this study was to identify risk factors for fractures after liver transplant in a Taiwanese population.Methods We identified newly diagnosed liver transplant recipients from the National Health Insurance Research Database in Taiwan between 2003 and 2015. Risk factors of post-transplant fractures were analyzed using a Cox proportional hazards model.Results A total of 4821 patients underwent liver transplantation, of whom 419 (8.7%) had post-transplant fractures. Independent predictors of post-transplant fractures were age ≥65 years at transplantation (hazard ratio (HR): 1.566; 95% confidence interval (CI) 1.122–2.186), female sex (HR: 1.648; 95% CI 1.319–2.057), fractures within 1 year prior to transplant (HR: 3.664; 95% CI 2.503–5.364), hepatitis C carriers (HR: 1.594; 95% CI 1.289–1.970), alcoholism (HR: 1.557; 95% CI 1.087–2.230) and daily prednisolone dose >1.61–3.78 mg/day (HR: 1.354; 95% CI 1.005–1.824), >3.78–9.18 mg (HR: 4.182; 95% CI 3.155–5.544) and >9.18 mg (HR: 13.334; 95% CI 9.506–18.703). Post-transplant fractures were inversely correlated with tacrolimus (HR: 0.617; 95% CI 0.417–0.913) and sirolimus/everolimus (HR: 0.504; 95% CI 0.391–0.650) treatment.Conclusions The liver transplant recipients, and especially those who were aged ≥65 years, female, hepatitis C carriers, had a history of fractures within 1 year prior to transplant, alcoholism, and higher daily prednisolone dose were associated with an increased risk of post-transplant fractures. Conversely, the use of tacrolimus and sirolimus/everolimus was associated with a decreased risk of fractures. |
| first_indexed | 2024-03-08T13:35:32Z |
| format | Article |
| id | doaj.art-9608dabeeca64c9e94fc0699b4ae7fb7 |
| institution | Directory Open Access Journal |
| issn | 0785-3890 1365-2060 |
| language | English |
| last_indexed | 2024-03-08T13:35:32Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj.art-9608dabeeca64c9e94fc0699b4ae7fb72024-01-16T19:13:20ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602023-12-0155110.1080/07853890.2023.2230871Risk factors for fractures following liver transplantation: a population-based cohort studyJei-Wen Chang0Hui-Hsin Yang1Niang-Cheng Lin2Fang-Cheng Kuo3Tzu-Ching Lin4Hsin-Lin Tsai5Department of Pediatrics, Taipei Veterans General Hospital, Taipei, TaiwanFaculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanFaculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanFaculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanDepartment of Pediatrics, Taipei Veterans General Hospital, Taipei, TaiwanFaculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanAbstractBackground Liver transplant recipients have an increased risk of osteoporosis and fractures. The aim of this study was to identify risk factors for fractures after liver transplant in a Taiwanese population.Methods We identified newly diagnosed liver transplant recipients from the National Health Insurance Research Database in Taiwan between 2003 and 2015. Risk factors of post-transplant fractures were analyzed using a Cox proportional hazards model.Results A total of 4821 patients underwent liver transplantation, of whom 419 (8.7%) had post-transplant fractures. Independent predictors of post-transplant fractures were age ≥65 years at transplantation (hazard ratio (HR): 1.566; 95% confidence interval (CI) 1.122–2.186), female sex (HR: 1.648; 95% CI 1.319–2.057), fractures within 1 year prior to transplant (HR: 3.664; 95% CI 2.503–5.364), hepatitis C carriers (HR: 1.594; 95% CI 1.289–1.970), alcoholism (HR: 1.557; 95% CI 1.087–2.230) and daily prednisolone dose >1.61–3.78 mg/day (HR: 1.354; 95% CI 1.005–1.824), >3.78–9.18 mg (HR: 4.182; 95% CI 3.155–5.544) and >9.18 mg (HR: 13.334; 95% CI 9.506–18.703). Post-transplant fractures were inversely correlated with tacrolimus (HR: 0.617; 95% CI 0.417–0.913) and sirolimus/everolimus (HR: 0.504; 95% CI 0.391–0.650) treatment.Conclusions The liver transplant recipients, and especially those who were aged ≥65 years, female, hepatitis C carriers, had a history of fractures within 1 year prior to transplant, alcoholism, and higher daily prednisolone dose were associated with an increased risk of post-transplant fractures. Conversely, the use of tacrolimus and sirolimus/everolimus was associated with a decreased risk of fractures.https://www.tandfonline.com/doi/10.1080/07853890.2023.2230871Fractureglucocorticoidhepatitis Bhepatitis Cimmunosuppressantliver transplantation |
| spellingShingle | Jei-Wen Chang Hui-Hsin Yang Niang-Cheng Lin Fang-Cheng Kuo Tzu-Ching Lin Hsin-Lin Tsai Risk factors for fractures following liver transplantation: a population-based cohort study Annals of Medicine Fracture glucocorticoid hepatitis B hepatitis C immunosuppressant liver transplantation |
| title | Risk factors for fractures following liver transplantation: a population-based cohort study |
| title_full | Risk factors for fractures following liver transplantation: a population-based cohort study |
| title_fullStr | Risk factors for fractures following liver transplantation: a population-based cohort study |
| title_full_unstemmed | Risk factors for fractures following liver transplantation: a population-based cohort study |
| title_short | Risk factors for fractures following liver transplantation: a population-based cohort study |
| title_sort | risk factors for fractures following liver transplantation a population based cohort study |
| topic | Fracture glucocorticoid hepatitis B hepatitis C immunosuppressant liver transplantation |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2023.2230871 |
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