| アブストラクト | AIMS: Sodium-glucose co-transporter-2 (SGLT-2) inhibitor-induced weight loss might play a role in the debated elevated fracture risk with these agents. The aim of the current study was to investigate the association between SGLT-2 inhibitor use, changes in body mass index (BMI) and fracture risk. METHODS: A retrospective cohort study was conducted using data from the UK Clinical Practice Research Datalink (CPRD) GOLD (2013-2018). The study population (N = 34,960) consisted of adults with diabetes initiating a sulphonylurea or SGLT-2 inhibitor. Cox proportional hazards models estimated hazard ratios (HRs) for major osteoporotic fracture with SGLT-2 inhibitor use versus sulphonylurea use, stratified by change in BMI, average daily dose and cumulative dose. Analyses were adjusted for age, sex, lifestyle variables, comorbidities, and concomitant drug use. RESULTS: SGLT-2 inhibitor use was not associated with an increased fracture risk compared to sulphonylurea use (adjusted HR 1.19; 95% confidence interval (CI): 0.80-1.79). This finding remained consistent after stratification by BMI change. However, the highest cumulative dose category was associated with an increased fracture risk (adjusted HR: 2.10, 95 %CI: 1.11-3.99). CONCLUSION: SGLT-2 inhibitor use was not associated with increased osteoporotic fracture risk, irrespective of change in BMI. However, a high cumulative dose could be an important risk factor. |
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| 投稿者 | van Dalem, Judith; Werkman, Nikki C C; van den Bergh, Joop P; Rossi, Bernardette; Viggers, Rikke; Eastell, Richard; Burden, Andrea M; Stehouwer, Coen D A; Klungel, Olaf H; Brouwers, Martijn C G J; Driessen, Johanna H M |
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| 組織名 | Department of Clinical Pharmacy & Toxicology, Maastricht University Medical;Centre+, Maastricht, The Netherlands; Cardiovascular Research Institute;Maastricht, Maastricht University Medical Centre+, Maastricht, The Netherlands.;Maastricht, Maastricht University Medical Centre+, Maastricht, The Netherlands;;Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of;Pharmaceutical Sciences, Utrecht, The Netherlands.;Department of Internal Medicine and NUTRIM School for Nutrition and Translational;Research in Metabolism, Maastricht University, Maastricht, The Netherlands;;Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands.;Centre+, Maastricht, The Netherlands; Ministry for Health, Regulatory Affairs,;Central Procurement Unit, Health-Central Procurement and Supplies, San Gwann,;Malta.;Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Steno;Diabetes Center North Jutland, Department of Endocrinology, Aalborg University;Hospital, Aalborg, Denmark.;Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield,;UK.;Institute of Pharmaceutical Sciences, Department of Chemistry and Applied;Biosciences, ETH Zurich, Switzerland.;Department of Internal Medicine and Cardiovascular Research Institute Maastricht;(CARIM), Maastricht University Medical Centre+, Maastricht, The Netherlands.;Cardiovascular Research Institute Maastricht, Maastricht University Medical;Centre+, Maastricht, The Netherlands; Department of Internal Medicine, Division;of Endocrinology and Metabolic Disease, Maastricht University Medical Centre+,;Maastricht, The Netherlands.;Pharmaceutical Sciences, Utrecht, The Netherlands; Department of Internal;Medicine and NUTRIM School for Nutrition and Translational Research in;Metabolism, Maastricht University, Maastricht, The Netherlands. Electronic;address: J.H.M.Driessen@uu.nl. |
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