Abstract: Objective To investigate the incidence and risk factors of osteoporosis (OP) in chronic hepatitis B (CHB) patients treated with nucleos(t)ide analogues (NAs). Methods A total of 1000 cases (male 600 cases, female 400 cases) of CHB patients admitted to our hospital from January 2019 to June 2021 were divided into 3 groups according to the diagnostic criteria of based on the measurement T and Z values of bone density in the middle and distal 1/3 of the ulnar radius of the non-stressed side of the forearm: normal bone group, osteopenia group and osteoporosis group. The general data and related factors of OP were recorded. The risk factors of OP were analyzed with multivariate logistic regression analysis. Results Among the 1000 CHB patients, 36.8% had osteopenia, and 18.2% had OP. The results of multivariate logistic regression analysis showed that age (OR=1.06, 95%CI:1.02-1.11, P=0.005), female (OR=1.37, 95%CI: 1.56-2.13, P=0.015), low body mass index (BMI) (OR=0.88, 95%CI:0.81-0.97, P=0.015), creatinine level (OR=1.45, 95% CI: 1.97-2.03, P=0.025) and taking adefovir dipivoxil or tenofovir dipivoxil (OR=1.00, 95%CI: 1.14-7.45, P=0.028) were correlated with bone mineral density. The blood phosphorus levels of patients treated with adefovir or tenofovir were lower. Conclusion CHB patients treated with NAs are more likely to have osteopenia and OP. The risk of osteopenia and OP is positive correlated with age, gender, low BMI, elevated creatinine level and taking adefovir dipivoxil or tenofovir dipivoxil antiviral therapy. Early prevention and detection should be done to reduce or delay the occurrence of OP.

Key words: Osteopenia, Osteoporosis, Chronic hepatitis B, Nucleos(t)ide analogues, Risk factors