Use of Chinese Herbal Medicine Was Related to Lower Risk of Osteoporotic Fracture in Sarcopenia Patients: Evidence from Population-Based Health Claims

Abstract

Wei-Jen Chen,1– 4,* Hanoch Livneh,5 Hsin-Hua Li,1 Yu-Han Wang,4,* Ming-Chi Lu,6,7 Tzung-Yi Tsai,8– 10 Kuei-Yu Chien2 1Department of Chinese Medicine, Dalin Tzu chi Hospital, The Buddhist Tzu chi Medical Foundation, Chiayi, 62247, Taiwan; 2Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, 33301, Taiwan; 3School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, 97004, Taiwan; 4Center of Sports Medicine, Dalin Tzu chi Hospital, The Buddhist Tzu chi Medical Foundation, Chiayi, 62247, Taiwan; 5Rehabilitation Counseling Program, Portland State University, Portland, OR, 97207-0751, USA; 6Division of Allergy, Immunology and Rheumatology, Dalin Tzu chi Hospital, The Buddhist Tzu chi Medical Foundation, Chiayi, 62247, Taiwan; 7School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan; 8Department of Medical Research, Dalin Tzu chi Hospital, The Buddhist Tzu chi Medical Foundation, Chiayi, 62247, Taiwan; 9Department of Nursing, Tzu Chi University of Science and Technology, Hualien, 97004, Taiwan; 10Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, 70428, Taiwan*These authors contributed equally to this workCorrespondence: Kuei-Yu Chien; Tzung-Yi Tsai, Tel [phone], Fax [phone], Email [email protected]; [email protected]: With population aging, sarcopenia and its accompanying risk of osteoporotic fracture has drawn increased attention. Nowadays, while Chinese herbal medicine (CHM) is often used as complementary therapy for many medical conditions, its effect against likelihood of osteoporotic fracture among sarcopenia subjects was not fully elucidated yet. We therefore conducted a population-level study to compare osteoporotic fracture risk for sarcopenia persons with or without CHM use.Methods: Using the patient record from a nationwide insurance database, we recruited persons with newly diagnosed sarcopenia and simultaneously free of osteoporotic fracture between 2000 and 2010. Propensity score matching was then applied to randomly select sets of CHM users and non-CHM users. All of them were tracked until end of 2013 to measure the incidence and adjusted hazard ratios (HRs) for new new-onset fracture in multivariable Cox proportional hazards model.Results: Compared to non-CHM users, the CHM users indeed had a lower incidence of osteoporotic fracture (121.22 vs 156.61 per 1000 person-years). Use of CHM correlated significantly with a lower fracture likelihood after adjusting for potential covariates, and those receiving CHM treatment for more than two years experienced a remarkably lower risk by 73%. Uses of several herbal formulae were correlated to reduced risk of osteoporotic fracture, such as Caulis Spatholobi, Xuduan, Duzhong, Danshen, Shu-Jing-Huo-Xue-Tang, Du-Huo-Ji-Sheng-Tang, Shao-Yao-Gan-Cao-Tang, and Shen-Tong-Zhu-Yu -Tang.Conclusion: Our study depicted that cumulative CHM exposure was inversely associated with osteoporotic fracture risk in a duration-dependent manner, implying that CHM treatment may be embraced as routine care in preventing incident osteoporotic fracture.Keywords: sarcopenia, osteoporotic fracture, risk, Chinese herbal medicines, cohort study

Keywords

• sarcopenia
• osteoporotic fracture
• risk
• chinese herbal medicines
• cohort study