The incidence of fractures at various sites in newly treated patients with type 2 diabetes mellitus.

Autor:	Sarodnik C; NUTRIM Research School, Maastricht University, Maastricht, the Netherlands., Rasmussen NH; Steno Diabetes Center North Jutland, Aalborg University Hospital, Aalborg, Denmark., Bours SPG; Department of Internal Medicine, Maastricht University Medical Centre+, the Netherlands.; CAPHRI Research School, Maastricht University, Maastricht, the Netherlands., Schaper NC; Department of Internal Medicine, Maastricht University Medical Centre+, the Netherlands.; CAPHRI Research School, Maastricht University, Maastricht, the Netherlands.; CARIM Research School, Maastricht University, Maastricht, the Netherlands., Vestergaard P; Steno Diabetes Center North Jutland, Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark., Souverein PC; Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands., Jensen MH; Steno Diabetes Center North Jutland, Aalborg University Hospital, Aalborg, Denmark., Driessen JHM; NUTRIM Research School, Maastricht University, Maastricht, the Netherlands.; CARIM Research School, Maastricht University, Maastricht, the Netherlands.; Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands.; Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+, Maastricht, the Netherlands., van den Bergh JPW; NUTRIM Research School, Maastricht University, Maastricht, the Netherlands.; Department of Internal Medicine, Maastricht University Medical Centre+, the Netherlands.; Department of Internal Medicine, VieCuri Medical Center, Venlo, the Netherlands.
Jazyk:	angličtina
Zdroj:	Bone reports [Bone Rep] 2022 Aug 22; Vol. 17, pp. 101614. Date of Electronic Publication: 2022 Aug 22 (Print Publication: 2022).
DOI:	10.1016/j.bonr.2022.101614
Abstrakt:	Purpose: In this descriptive study, we examined the incidence of fractures in patients with newly treated type 2 diabetes mellitus (T2D) compared to matched reference population. Methods: Participants from the UK Clinical Practice research datalink (CPRD) GOLD (1987-2017), aged ≥30 years, with a T2D diagnosis code and a first prescription for a non-insulin anti-diabetic drug (n = 124,328) were included. Cases with T2D were matched by year of birth, sex and practice to a reference population (n = 124,328), the mean follow-up was 7.7 years. Crude fracture incidence rates (IRs) and incidence rate ratios (IRRs) were calculated. Analyses were stratified by fracture site and sex and additionally adjusted for BMI, smoking status, alcohol use and history of any fracture at index date. Results: The IR of all fractures and major osteoporotic fractures was lower in T2D compared to the reference population (IRR 0.97; 95%CI 0.94-0.99). The IRs were lower for clavicle (IRR 0.67; 0.56-0.80), radius/ulna (IRR 0.81; 0.75-0.86) and vertebral fractures (0.83; 0.75-0.92) and higher for ankle (IRR 1.16; 95%CI 1.06-1.28), foot (1.11; 1.01-1.22), tibia/fibula (1.17; 1.03-1.32) and humerus fractures (1.11; 1.03-1.20). Differences in IRs at various fracture sites between T2D and the reference population were more pronounced in women than in men. In contrast, BMI adjusted IRs for all fractures (IRR 1.07; 1.04-1.10) and most individual fracture sites were significantly higher in T2D, especially in women. Conclusion: The crude incidence of all fractures was marginally lower in patients with newly treated T2D compared to the matched reference population but differed according to fracture site, especially in women. BMI adjusted analyses resulted in higher incidence rates in T2D at almost all fracture sites compared to crude incidence rates and this was more pronounced in women than in men. This implies that BMI may have a protective impact on the crude incidence of fractures, especially in women with newly treated T2D. Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Joop van den Bergh is involved in research that is sponsored by Amgen, Eli Lilly and UCB. Peter Vestergaard is head of research in the Steno Diabetes Center North Jutland sponsored by the Novo Nordisk Foundation. The other authors, Cindy Sarodnik, Nicklas Rasmussen, Sandrine Bours, Nicolaas Schaper, Patrick Souverein, Morten Jensen, and Johanna Driessen, declare that they have no conflict of interest. (© 2022 The Authors.)
Databáze:	MEDLINE
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