Association of sepsis with risk for osteoporosis: a population-based cohort study

Lee, Yi-Ting; Tsou, Hsi‐Kai; Leong, Pui‐Ying; Wang, Y.-H.; Wei, James Cheng‐Chung

doi:10.1007/s00198-020-05599-3

Cited by 6 publications

(5 citation statements)

References 30 publications

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“…Long-term administration of glucocorticoids in pulmonary disease and multifactorial inhibitory influences on osteoblastic cell function (sclerostin, retained substances of cholestasis, alcohol) are suspected. While the underlying causes of potential interactions between sepsis and osteoporosis have not yet been established, a recently published study demonstrated an association between these two conditions in younger patients in particular (<65 years of age) in a national study cohort of >13,000 patients in Taiwan [19]. These findings coincide well with our results.…”

Section: Discussionsupporting

confidence: 92%

Decreased Bone Mineral Density Is a Predictor of Poor Survival in Critically Ill Patients

Schulze-Hagen

Roderburg

Wirtz

et al. 2021

JCM

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Alterations in bone mineral density (BMD) have been suggested as independent predictors of survival for several diseases. However, little is known about the role of BMD in the context of critical illness and intensive care medicine. We therefore evaluated the prognostic role of BMD in critically ill patients upon admission to an intensive care unit (ICU). Routine computed tomography (CT) scans of 153 patients were used to assess BMD in the first lumbar vertebra. Results were correlated with clinical data and outcomes. While median BMD was comparable between patients with and without sepsis, BMD was lower in patients with pre-existing arterial hypertension or chronic obstructive pulmonary disease. A low BMD upon ICU admission was significantly associated with impaired short-term ICU survival. Moreover, patients with baseline BMD < 122 HU had significantly impaired overall survival. The prognostic relevance of low BMD was confirmed in uni- and multivariate Cox-regression analyses including several clinicopathological parameters. In the present study, we describe a previously unrecognised association of individual BMD with short- and long-term outcomes in critically ill patients. Due to its easy accessibility in routine CT, BMD provides a novel prognostic tool to guide decision making in critically ill patients.

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Section: Discussionsupporting

confidence: 92%

Decreased Bone Mineral Density Is a Predictor of Poor Survival in Critically Ill Patients

Schulze-Hagen

Roderburg

Wirtz

et al. 2021

JCM

View full text Add to dashboard Cite

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“…The overall incidence of osteoporosis was 10.2 and 10.7 (per 1,000 person-years) in the sepsis and non-sepsis groups, respectively. Sepsis significantly increased the risk of osteoporosis (adjusted HR 1.17, 95% CI: 1.04–1.31), particularly in adults younger than 65 years [43]. Limitations of the study are the residual confounding effects of unmeasured parameters such as medication exposures, other risk factors for osteoporosis, and acute illness characteristics during the hospitalization with sepsis, as well as the relative short study follow-up.…”

Section: Bone Health In Akimentioning

confidence: 99%

Bone Dysregulation in Acute Kidney Injury

Neyra,

Moe

2023

Nephron

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Acute kidney injury (AKI) is a highly prevalent condition with multiple acute and chronic consequences. Survivors of AKI are at risk of AKI-to-chronic kidney disease (CKD) transition, which carries significant morbidity and mortality. One retrospective analysis showed increased risk of bone fracture post-AKI in humans, which was independent of CKD development. While there are several theoretical reasons for late disturbances of bone health post-AKI, no definitive data are available to date. An important question is whether there are bone sequelae from AKI that are independent of CKD, meaning bone disease prior to the onset, or in the absence of CKD – a form of “post-AKI osteopathy”. While pre-clinical studies examining bone health after acute stressors have focused mostly on sepsis models, multiple experimental AKI models are readily available for longitudinal bone health interrogation. Future research should be tailored to define whether AKI is a risk factor, independent of CKD, for bone disease and if present, the time course and type of bone disease. This review summarizes a fraction of the existing data to provide some guidance in future research efforts.

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“…In a retrospective study of patients initially treated for sepsis with absolute increase > 2 in Sequential Organ Failure Assessment score, significant bone loss was observed in the thoracic, lumbar, and sacral spine regions (Hongo et al, 2019). A second retrospective study showed that sepsis patients had an increased risk for developing osteoporosis compared to non-sepsis patients (Lee et al, 2020). In addition to bone loss, sepsis has been linked to heterotopic ossification, the abnormal formation of lamellar bone in connective tissue.…”

Section: Septicemia/sepsismentioning

confidence: 99%

Effects of Neurological Disorders on Bone Health

2020

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Neurological diseases, particularly in the context of aging, have serious impacts on quality of life and can negatively affect bone health. The brain-bone axis is critically important for skeletal metabolism, sensory innervation, and endocrine cross-talk between these organs. This review discusses current evidence for the cellular and molecular mechanisms by which various neurological disease categories, including autoimmune, developmental, dementia-related, movement, neuromuscular, stroke, trauma, and psychological, impart changes in bone homeostasis and mass, as well as fracture risk. Likewise, how bone may affect neurological function is discussed. Gaining a better understanding of brain-bone interactions, particularly in patients with underlying neurological disorders, may lead to development of novel therapies and discovery of shared risk factors, as well as highlight the need for broad, whole-health clinical approaches toward treatment.

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Association of sepsis with risk for osteoporosis: a population-based cohort study

Cited by 6 publications

References 30 publications

Decreased Bone Mineral Density Is a Predictor of Poor Survival in Critically Ill Patients

Decreased Bone Mineral Density Is a Predictor of Poor Survival in Critically Ill Patients

Bone Dysregulation in Acute Kidney Injury

Effects of Neurological Disorders on Bone Health

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