Type 1 and type 2 diabetes and incident hip fractures in postmenopausal women
Type 1 and type 2 diabetes and incident hip fractures in postmenopausal women
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DOI：
10.2337/diacare.24.7.1192
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发表时间：
2001-07-01
期刊：
影响因子：
16.2
通讯作者：
Folsom, AR
中科院分区：
文献类型：
--
作者：
Nicodemus, KK;Folsom, AR
目的：研究绝经后糖尿病妇女髋部骨折的发生率是否高于非糖尿病妇女。研究设计和方法--1986年通过邮寄方式对居住在爱荷华州的32，089名绝经后妇女进行了前瞻性队列调查，并随访了11年。糖尿病状态和其他潜在的危险因素进行了评估，在基线的调查问卷，髋部骨折的发病率进行了确定的后续questionnaire.RESULTS -共490髋部骨折超过306,900人年的后续报告。在调整年龄、吸烟状况、雌激素使用、BMI和腰臀比后，1型糖尿病女性（n = 47）报告髋部骨折的可能性是非糖尿病女性的12.25倍（95%CI 5.05-29.73）。患有2型糖尿病的女性发生髋部骨折的风险比没有糖尿病的女性高1.70倍（1.21-2.38）。2型糖尿病的持续时间越长，发病率越高，2型糖尿病女性使用胰岛素或口服糖尿病药物也是如此。此外，与从未患过糖尿病的女性相比，最初没有糖尿病但发展为糖尿病的女性发生髋部骨折的相对风险为1.60（1.14-2.25）。结论-患有糖尿病或发展为糖尿病的绝经后女性比非糖尿病绝经后女性发生髋部骨折的风险更高。预防骨质疏松症和/或跌倒的策略可能特别适用于糖尿病女性。
OBJECTIVE - To examine whether postmenopausal women with diabetes experienced a higher incidence of hip fracture than women without diabetes. RESEARCHDESIGN AND METHODS - A prospective cohort of 32,089 postmenopausal women residing in Iowa were surveyed by mail in 1986 and followed for 11 years. Diabetes status and other potential risk factors were assessed by questionnaires at baseline; incidence of hip fracture was ascertained by follow-up questionnaires.RESULTS - A total of 490 hip fractures were reported over 306,900 person-years of followup. After adjustment for age, smoking status, estrogen use, BMI, and waist-to-hip ratio, women with type 1 diabetes (n = 47) were 12.25 times (95% CI 5.05-29.73) more likely to report an incident hip fracture than women without diabetes. Women with type 2 diabetes had a 1.70-fold higher risk (1.21-2.38) of incident hip fracture than women without diabetes. Longer duration of type 2 diabetes was associated with higher incidence, as was use of insulin or oral diabetes medications in women with type 2 diabetes. Furthermore, women who were initially free of diabetes but in whom diabetes developed had a relative risk of hip fracture of 1.60 (1.14-2.25) compared with women who never had diabetes.CONCLUSIONS - Postmenopausal women who have diabetes or in whom diabetes develops are at higher risk for hip fracture than nondiabetic postmenopausal women. Strategies to prevent osteoporosis and/or falling may be especially warranted in women with diabetes.