Intensive glycemic control is not associated with fractures or falls in the ACCORD randomized trial.
Intensive glycemic control is not associated with fractures or falls in the ACCORD randomized trial.
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DOI：
10.2337/dc11-2184
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发表时间：
2012-07
期刊：
影响因子：
16.2
通讯作者：
Bauer DC
中科院分区：
文献类型：
--
作者：
Schwartz AV;Margolis KL;Sellmeyer DE;Vittinghoff E;Ambrosius WT;Bonds DE;Josse RG;Schnall AM;Simmons DL;Hue TF;Palermo L;Hamilton BP;Green JB;Atkinson HH;O'Connor PJ;Force RW;Bauer DC
老年2型糖尿病患者骨折和福尔斯的风险很高，但血糖控制对这些结果的影响尚不清楚。为了确定强化血糖控制与标准血糖控制的效果，我们在控制糖尿病心血管风险行动（雅阁）随机试验中评估了骨折和福尔斯的结局。雅阁参与者被随机分配到强化或标准治疗策略，达到的A1 C中位数分别为6.4%和7.5%。在雅阁BONE辅助研究中，在77家雅阁临床试验机构中的54家评估了骨折，其中包括10，251名雅阁参与者中的7，287名。在年度访问中，6,782名参与者被问及前一年的福尔斯。在平均3.8年（SD 1.3）的随访中，3，655名强化腰椎间盘突出症患者中有198人，3，632名标准腰椎间盘突出症患者中有189人至少发生了一次非脊柱骨折。强化组和标准组的首次非脊柱骨折平均发生率分别为13.9/1000人-年和13.3/1000人-年（风险比1.04 [95%CI 0.86-1.27]）。在平均2.0年的随访期间，3，364名强化治疗参与者中有1，122名和3，418名标准治疗参与者中有1，133名报告至少有一次跌倒。强化和标准治疗组的平均福尔斯跌倒率分别为60.8和55.3/100人-年（1.10 [0.84-1.43]）。雅阁组与标准悬吊术组相比，强化悬吊术并没有增加或减少骨折或跌倒的风险。
Older adults with type 2 diabetes are at high risk of fractures and falls, but the effect of glycemic control on these outcomes is unknown. To determine the effect of intensive versus standard glycemic control, we assessed fractures and falls as outcomes in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) randomized trial. ACCORD participants were randomized to intensive or standard glycemia strategies, with an achieved median A1C of 6.4 and 7.5%, respectively. In the ACCORD BONE ancillary study, fractures were assessed at 54 of the 77 ACCORD clinical sites that included 7,287 of the 10,251 ACCORD participants. At annual visits, 6,782 participants were asked about falls in the previous year. During an average follow-up of 3.8 (SD 1.3) years, 198 of 3,655 participants in the intensive glycemia and 189 of 3,632 participants in the standard glycemia group experienced at least one nonspine fracture. The average rate of first nonspine fracture was 13.9 and 13.3 per 1,000 person-years in the intensive and standard groups, respectively (hazard ratio 1.04 [95% CI 0.86–1.27]). During an average follow-up of 2.0 years, 1,122 of 3,364 intensive- and 1,133 of 3,418 standard-therapy participants reported at least one fall. The average rate of falls was 60.8 and 55.3 per 100 person-years in the intensive and standard glycemia groups, respectively (1.10 [0.84–1.43]). Compared with standard glycemia, intensive glycemia did not increase or decrease fracture or fall risk in ACCORD.
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影响因子：
6.3
作者：
LaCroix AZ;Lee JS;Wu L;Cauley JA;Shlipak MG;Ott SM;Robbins J;Curb JD;Leboff M;Bauer DC;Jackson RD;Kooperberg CL;Cummings SR;Women's Health Initiative Observational
通讯作者：
Women's Health Initiative Observational
DOI：
10.1056/nejmoa1001288
发表时间：
2010-07-15
期刊：
The New England journal of medicine
影响因子：
--
作者：
ACCORD Study Group;ACCORD Eye Study Group;Chew EY;Ambrosius WT;Davis MD;Danis RP;Gangaputra S;Greven CM;Hubbard L;Esser BA;Lovato JF;Perdue LH;Goff DC Jr;Cushman WC;Ginsberg HN;Elam MB;Genuth S;Gerstein HC;Schubart U;Fine LJ
通讯作者：
Fine LJ
影响因子：
8.2
作者：
Forsén, L;Meyer, HE;Edna, TH
通讯作者：
Edna, TH
影响因子：
16.2
作者：
Ivers, RQ;Cumming, RG;Peduto, AJ
通讯作者：
Peduto, AJ
影响因子：
1.9
作者：
CRAGER, MR
通讯作者：
CRAGER, MR