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Increased risk of benign paroxysmal positional vertigo in osteoporosis: a nationwide population-based cohort study.

Abstract
Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo, which results from dislodged vestibular otoliths. Because the otoliths are mainly composed of calcium carbonate, it has been suggested that BPPV may be associated with osteoporosis. We aimed to assess the incidence and recurrence of BPPV in osteoporosis patients using a nationwide population-based cohort study with matched control. We used the database of the National Health Insurance Service of Korea, a universal system covering all 50 million Koreans. Osteoporosis was defined as patients who underwent bone mineral density tests and visited a clinic three or more times between Jan 2004 and Dec 2006. A control cohort consisted of non-osteoporotic subjects socio-demographically matched in a ratio of 1:1. The incidence and recurrence of BPPV between Jan 2007 and Dec 2016 were evaluated. A total of 177,797 osteoporosis patients and the same number of matched controls were identified. The incidence rates (IR) of BPPV in the osteoporosis patients and controls were 31.58 and 18.09 per 1000 persons, respectively (ratio of IR, IRR = 1.75, 95% CI 1.67-1.83). The IRs of recurrent BPPV were 187.3/1000 in the osteoporosis, 163.5/1000 in the controls (IRR = 1.15, 95% CI 1.02-1.28). In multivariate analysis, osteoporosis, female gender (adjusted HR = 1.76), age <65 (adjusted HR = 0.8), living in a metropolis, earning more than the lowest income and hypertension were significantly associated with increased risk of BPPV development. For recurrence, osteoporosis was the only meaningful risk factor (adjusted HR = 1.12). In conclusion, the risks of BPPV development and recurrence are higher in osteoporosis. Physicians might consider informing osteoporosis patients of the risk of developing BPPV and related falls.
AuthorsHayoung Byun, Jae Ho Chung, Seung Hwan Lee, Chul Won Park, Eun Mi Kim, Inah Kim
JournalScientific reports (Sci Rep) Vol. 9 Issue 1 Pg. 3469 (03 05 2019) ISSN: 2045-2322 [Electronic] England
PMID30837524 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Aged
  • Aged, 80 and over
  • Benign Paroxysmal Positional Vertigo (epidemiology, etiology)
  • Disease Susceptibility
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Osteoporosis (complications, epidemiology)
  • Population Surveillance
  • Prevalence
  • Republic of Korea (epidemiology)
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors

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