Association of BMD and FRAX score with risk of fracture in older adults with type 2 diabetes.
Association of BMD and FRAX score with risk of fracture in older adults with type 2 diabetes.
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DOI：
10.1001/jama.2011.715
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发表时间：
2011-06-01
影响因子：
120.7
通讯作者：
Black, Dennis M.
中科院分区：
文献类型：
--
作者：
Schwartz, Ann V.;Vittinghoff, Eric;Bauer, Douglas C.;Hillier, Teresa A.;Strotmeyer, Elsa S.;Ensrud, Kristine E.;Donaldson, Meghan G.;Cauley, Jane A.;Harris, Tamara B.;Koster, Annemarie;Womack, Catherine R.;Palermo, Lisa;Black, Dennis M.
2型糖尿病与更高的骨密度(BMD)相关，矛盾的是，还与骨折风险增加有关。目前尚不清楚低骨密度是否能确定糖尿病患者的骨折风险。低骨密度是预测老年人骨折的核心因素。确定老年糖尿病患者股骨颈(FN)BMD、T-Score和FRAX评分是否与骨折有关。三项观察性研究：骨质疏松性骨折研究，男性骨质疏松性骨折研究，以及健康、衰老和身体成分研究。在美国社区居住的老年人中，有9449名女性；7436名男性。自行报告的事故骨折，经放射学报告核实。在770名糖尿病妇女中，84人在平均12.6(5.3)年的随访期内经历了髋部骨折和262例非脊柱骨折。在1199名糖尿病男性中，32人经历了髋部骨折，133人经历了非脊柱骨折，平均随访时间为7.9(2.5)年。糖尿病女性FN BMD T-Score降低一个单位的年龄调整危险比(HR)：髋部为1.88(95%可信区间，1.43-2.48)，非脊柱骨折为1.52(95%可信区间，1.31-1.75)。糖尿病男性髋部骨折的HR为5.71(95%CI，3.42~9.53)，非脊柱骨折的HR为2.17(95%CI，1.75~2.69)。糖尿病患者的FRAX评分也与骨折风险相关。然而，对于给定的T评分和年龄或FRAX评分，糖尿病参与者比非糖尿病患者有更高的骨折风险。对于类似的髋部骨折风险，糖尿病参与者的T-Score高于非糖尿病参与者。女性T分差为0.59(95%CI，0.31~0.87)，男性T分差为0.38(95%CI，0.09~0.66)。在患有2型糖尿病的老年人中，FN BMD T评分和FRAX评分与髋部和非脊柱骨折风险相关。然而，在这些患者中，与没有糖尿病的参与者相比，在给定的T评分和年龄或给定的FRAX评分下，骨折风险更高。
Type 2 diabetes is associated with higher bone density (BMD) and, paradoxically, with increased fracture risk. It is not known if low BMD, central to fracture prediction in older adults, identifies fracture risk in diabetic patients. Determine if femoral neck (FN) BMD T-score and FRAX score are associated with fracture in older diabetic adults. Three observational studies: Study of Osteoporotic Fractures, Osteoporotic Fractures in Men, and Health, Aging and Body Composition study. Older community-dwelling adults in U.S. 9,449 women; 7,436 men. Self-reported incident fractures, verified by radiology reports. Of 770 diabetic women, 84 experienced a hip and 262 a non-spine fracture during mean (SD) follow-up of 12.6 (5.3) years. Of 1,199 diabetic men, 32 experienced a hip and 133 a non-spine fracture during mean follow-up of 7.9 (2.5) years. Age-adjusted hazard ratios (HR) for one unit decrease in FN BMD T-score in diabetic women were 1.88 (95% confidence interval [CI], 1.43–2.48) for hip and 1.52 (95% CI, 1.31–1.75) for non-spine fracture. HRs in diabetic men were 5.71 (95% CI, 3.42–9.53) for hip and 2.17 (95% CI, 1.75–2.69) for non-spine fracture. FRAX score was also associated with fracture risk in diabetic participants. However, for a given T-score and age or FRAX score, diabetic participants had a higher fracture risk than those without diabetes. For a similar hip fracture risk, diabetic participants had a higher T-score than non-diabetic participants. The difference in T-score was 0.59 (95% CI, 0.31–0.87) for women and 0.38 (95% CI, 0.09–0.66) for men. Among older adults with type 2 diabetes, FN BMD T-score and FRAX score were associated with hip and non-spine fracture risk. However, in these patients, compared with participants without diabetes, fracture risk was higher for a given T-score and age or a given FRAX score.
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影响因子：
2.2
作者：
Orwoll, E;Blank, JB;Stone, K
通讯作者：
Stone, K
影响因子：
16.2
作者：
Cowie CC;Rust KF;Ford ES;Eberhardt MS;Byrd-Holt DD;Li C;Williams DE;Gregg EW;Bainbridge KE;Saydah SH;Geiss LS
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影响因子：
16.2
作者：
Schwartz, AV;Hillier, TA;Cummings, SR
通讯作者：
Cummings, SR
影响因子：
6.2
作者：
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通讯作者：
Tenenhouse, A
影响因子：
5.8
作者：
Bonds, Denise E.;Larson, Joseph C.;Margolis, Karen L.
通讯作者：
Margolis, Karen L.