Ying-Yi Lu1,2,3, Chieh-Hsin Wu4,5, Chun-Ching Lu6,7, Hao Qin8, Zi-Hao Zhang9, Cong-Liang Zhang10. 1. Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, 81362, Taiwan. actinp@hotmail.com. 2. Shu-Zen Junior College of Medicine and Management, Kaohsiung, 82144, Taiwan. actinp@hotmail.com. 3. Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan. actinp@hotmail.com. 4. Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, 80756, Taiwan. wujoeys@gmail.com. 5. Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan. wujoeys@gmail.com. 6. Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, 11217, Taiwan. 7. Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, 11221, Taiwan. 8. Department of Neurosurgery, Zaozhuang Municipal Hospital, Zaozhuang, Shandong, 277102, People's Republic of China. 9. Department of Neurosurgery, The No.7 People's Hospital of Hebei Province, Dingzhou, Hebei, 073000, People's Republic of China. 10. Department of Cardiology, Hebei Quyang Renji Hospital, Quyang, Hebei, 073100, Taiwan.
Abstract
BACKGROUND: Keloids are characterized by disturbance of fibroblast proliferation and apoptosis, deposition of collagen, and upregulation of dermal inflammation cells. This benign dermal fibro-proliferative scarring condition is a recognized skin inflammation disorder. Chronic inflammation is a well-known contributor to bone loss and its sequelae, osteoporosis. They both shared a similar pathogenesis through chronic inflammation. We assessed whether keloids increase osteoporosis risk through using National Health Insurance Research Database. METHODS: The 42,985 enrolled patients included 8597 patients with keloids but no history of osteoporosis; 34,388 controls without keloids were identified from the general population and matched at a one-to-four ratio by age, gender. Kaplan-Meier method was applied to determine cumulative incidence of osteoporosis. Cox proportional hazard regression analysis was performed after adjustment of covariates to estimate the effect of keloids on osteoporosis risk. RESULTS: Of the 8597 patients with keloids, 178 (2.07%) patients were diagnosed with osteoporosis while in the 34,388 controls, 587 (1.71%) were diagnosed with osteoporosis. That is, the keloids patients had 2.64-fold higher risk of osteoporosis compared to controls after adjustment for age, gender, Charlson Comorbidity Index and related comorbidities. The association between keloids and osteoporosis was strongest in patients younger than 50 years (hazard ratio = 7.06%) and in patients without comorbidities (hazard ratio = 4.98%). In the keloids patients, a high incidence of osteoporosis was also associated with advanced age, high Charlson Comorbidity Index score, hyperlipidemia, chronic liver disease, stroke, and depression. CONCLUSIONS: Osteoporosis risk was higher in patients with keloids compared to controls, especially in young subjects and subjects without comorbidities.
BACKGROUND: Keloids are characterized by disturbance of fibroblast proliferation and apoptosis, deposition of collagen, and upregulation of dermal inflammation cells. This benign dermal fibro-proliferative scarring condition is a recognized skin inflammation disorder. Chronic inflammation is a well-known contributor to bone loss and its sequelae, osteoporosis. They both shared a similar pathogenesis through chronic inflammation. We assessed whether keloids increase osteoporosis risk through using National Health Insurance Research Database. METHODS: The 42,985 enrolled patients included 8597 patients with keloids but no history of osteoporosis; 34,388 controls without keloids were identified from the general population and matched at a one-to-four ratio by age, gender. Kaplan-Meier method was applied to determine cumulative incidence of osteoporosis. Cox proportional hazard regression analysis was performed after adjustment of covariates to estimate the effect of keloids on osteoporosis risk. RESULTS: Of the 8597 patients with keloids, 178 (2.07%) patients were diagnosed with osteoporosis while in the 34,388 controls, 587 (1.71%) were diagnosed with osteoporosis. That is, the keloids patients had 2.64-fold higher risk of osteoporosis compared to controls after adjustment for age, gender, Charlson Comorbidity Index and related comorbidities. The association between keloids and osteoporosis was strongest in patients younger than 50 years (hazard ratio = 7.06%) and in patients without comorbidities (hazard ratio = 4.98%). In the keloids patients, a high incidence of osteoporosis was also associated with advanced age, high Charlson Comorbidity Index score, hyperlipidemia, chronic liver disease, stroke, and depression. CONCLUSIONS:Osteoporosis risk was higher in patients with keloids compared to controls, especially in young subjects and subjects without comorbidities.
Entities:
Keywords:
Epidemiology; Inflammation; Keloid; Osteoporosis; Population-based study
Authors: Vito Pavone; Gianluca Testa; Serena M C Giardina; Andrea Vescio; Domenico A Restivo; Giuseppe Sessa Journal: Front Pharmacol Date: 2017-11-07 Impact factor: 5.810