| アブストラクト | AIM: To determine the association of diabetes-related characteristics with fractures at different sites in individuals with type 2 diabetes (T2D). MATERIALS AND METHODS: We conducted a cohort study using the Clinical Practice Research Datalink (CPRD) GOLD. Patients aged over 30 years with T2D were identified within the CPRD. Patients were followed from the start of diabetes treatment until the end of data collection, death, or the occurrence of a fracture. Cox proportional hazards models were used to estimate the hazard ratios for the association of the individual characteristics (diabetes duration, glycated haemoglobin [HbA1c] level, and microvascular complications) with fracture risk, adjusted for demographics, comorbidities and comedication. RESULTS: A diabetes duration of >10 years was associated with an increased risk of any fracture and major osteoporotic fractures (MOFs), while a diabetes duration of >8 years was associated with an increased hip fracture risk, compared to a duration <2 years. An HbA1c level <6% was associated with an increased fracture risk compared to HbA1c values of 6% to <7%. The presence of one or two microvascular complications was associated with an increased risk of any fracture and MOFs and the presence of two microvascular complications was associated with an increased hip fracture risk, compared to no microvascular complications. CONCLUSION: In conclusion, our study shows that a diabetes duration of 10 years or more, strict glycaemic control resulting in HbA1c levels below 6%, and/or the presence of at least one microvascular complication increased the risk of any fracture, hip fractures, MOFs, and humerus fractures, but not ankle, scapula or skull fractures. |
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| 投稿者 | van Hulten, Veerle; Souverein, Patrick C; Starup-Linde, Jakob; Viggers, Rikke; Klungel, Olaf H; Vestergaard, Peter; Brouwers, Martijn C J G; van den Bergh, Joop P; Driessen, Johanna H M |
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| 組織名 | Department of Clinical Pharmacy and Toxicology, Maastricht University Medical;Centre+ (MUMC+), Maastricht, The Netherlands.;School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht;University, Maastricht, The Netherlands.;Department of Clinical Pharmacy, Cardiovascular Research Institute Maastricht;(CARIM), Maastricht University, Maastricht, The Netherlands.;Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for;Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.;Department of Endocrinology and Internal Medicine, Aarhus University Hospital,;Aarhus, Denmark.;Steno Diabetes Center North Denmark, Aalborg, Denmark.;Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.;Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.;Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+),;Maastricht, The Netherlands.;Cardiovascular Research Institute Maastricht (CARIM), Maastricht University,;Care and Public Health Research Institute (CAPHRI), Maastricht University,;Department of Internal Medicine, Division of Rheumatology, Maastricht University;Medical Centre+ (MUMC+), Maastricht, The Netherlands.;Department of Internal Medicine, Subdivision of Endocrinology, VieCuri Medical;Center, Venlo, The Netherlands. |
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