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Osteoporosis International
Published in: Osteoporosis International 4/2024

23-12-2023 | Bronchial Asthma | Original Article

Higher risk of osteoporosis in adult-onset asthma than childhood-onset asthma: from genetic and prospective evidence

Authors: Weizhong Ding, Yong Huang, Guanghui Li, Yimin Dong, Xiaochen Li, Minglong Wu, Kehan Song, Feng Li

Published in: Osteoporosis International | Issue 4/2024

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Abstract

Summary

Both COA and AOA have a genetically causal effect on osteoporosis. COA and AOA were independently associated with incident osteoporosis, and the risk was greatly higher in AOA. Besides corticosteroids, the increased risk of osteoporosis among asthma patients should be attributed to genetic susceptibility and other asthma medications.

Purpose/Introduction

Childhood-onset asthma (COA) differs with adult-onset asthma (AOA) on genetic susceptibility, severity, and co-morbidities. Whether COA or AOA is independently associated with osteoporosis is unexplored. We aimed to determine the effects of COA and AOA on osteoporosis at genetic and individual level.

Methods

We used two-sample Mendelian randomization analysis to explore the causal effects of COA and AOA on osteoporosis. In the UK Biobank cohort, we included 478,289 osteoporosis-free participants at baseline (2006–2010). Participants were classified as non-asthma, COA, and AOA at recruitment. Multivariate Cox regression analysis was used to evaluate the effects of COA, AOA, and multiple asthma medications on incident osteoporosis risk.

Results

COA and AOA were causally related to osteoporosis, with odds ratio of 1.007 (95% confidence interval (CI), 1.0003–1.0132) and 1.012 (95% CI, 1.002–1.023), respectively. Multivariate Cox regression analysis suggested that COA (hazard ratio (HR), 1.46; 95% CI, 1.32–1.61) and AOA (HR, 1.70; 95% CI, 1.61–1.80) were independently associated with incident osteoporosis, and the risk was greatly higher in AOA (HR, 1.51; 95% CI, 1.34–1.70). In addition to corticosteroids, monotherapy with leukotriene modifiers (HR, 1.70; 95% CI, 1.20–2.42), long-acting beta agonists (HR, 1.49; 95% CI, 1.18–1.87), and short-acting beta agonists (HR, 1.72; 95% CI1.01–2.93) were independently associated with a higher risk of osteoporosis.

Conclusions

Both COA and AOA have a genetically causal effect on osteoporosis, and the risk of osteoporosis is greatly higher in AOA. Besides corticosteroids, the increased risk of osteoporosis among asthma patients should be attributed to genetic susceptibility and other asthma medications.
Appendix
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Metadata
Title
Higher risk of osteoporosis in adult-onset asthma than childhood-onset asthma: from genetic and prospective evidence
Authors
Weizhong Ding
Yong Huang
Guanghui Li
Yimin Dong
Xiaochen Li
Minglong Wu
Kehan Song
Feng Li
Publication date
23-12-2023
Publisher
Springer London
Published in
Osteoporosis International / Issue 4/2024
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-023-07004-1

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