Diabetes and risk of fracture - The Blue Mountains Eye Study
Diabetes and risk of fracture - The Blue Mountains Eye Study
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DOI：
10.2337/diacare.24.7.1198
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发表时间：
2001-07-01
期刊：
影响因子：
16.2
通讯作者：
Peduto, AJ
中科院分区：
文献类型：
--
作者：
Ivers, RQ;Cumming, RG;Peduto, AJ
研究设计和方法--这是一项前瞻性研究，研究对象为3,654名年龄在49岁及以上的澳大利亚悉尼西部蓝山居民。在基线时，受试者被问到关于糖尿病病史和治疗的问题，并采集了空腹血液样本。拍摄视网膜和晶状体的照片，对视网膜病变和白内障进行分级。通过自我报告和病历搜索相结合的方法收集骨折细节(不包括肋骨和脊椎骨折)；结果：经过2年的随访，我们发现糖尿病相关因素(在多因素模型中)与所有骨折合并风险的增加显著相关，包括糖尿病视网膜病变(调整后的RR 5.4，95%CI 2.7-10.8)，糖尿病病程大于或等于10年(3.3，1.3-8.2)，累及晶状体面积大于或等于25%的皮质性白内障(2.5，1.3-4.7)，以及胰岛素治疗(5.9，2.6-13.5)。肱骨近端是唯一与糖尿病相关的个体骨折部位。糖尿病视网膜病变(10.3，2.2-48.0)、糖尿病病程(病程大于或等于10年；11.4，2.4-54.2)和胰岛素治疗(18.8，4.0-88.7)都与肱骨近端骨折相关。结论--这些数据表明，糖尿病视网膜病变、晚期皮质白内障、糖尿病病程较长和胰岛素治疗显著增加了骨折的风险。然而，这项研究存在一些缺陷，可能会限制这些发现。
OBJECTIVE - To examine associations between measures of diabetes and risk of fracture in a population-based sample of older Australians.RESEARCH DESIGN AND METHODS - This was a prospective study of 3,654 subjects aged 49 years and older who were residents in the Blue Mountains, west of Sydney, Australia. At baseline, subjects were asked questions about history and treatment of diabetes, and fasting blood samples were taken. Photographs were taken of the retina and lens to grade retinopathy and cataract. Details of fractures (excluding rib and vertebral fractures) were collected by a combination of self-report and medical record searches; all fractures were radiologically confirmed.RESULTS - After 2 years of follow-up, we found that several diabetes-related factors were significantly associated (in multivariate models) with increased risk of all fractures combined, including presence of diabetic retinopathy (adjusted RR 5.4, 95% CI 2.7-10.8), diabetes duration greater than or equal to 10 years (3.3, 1.3-8.2), cortical cataract involving greater than or equal to 25% of the lens area (2.5, 1.3-4.7), and insulin treatment (5.9, 2.6-13.5). The proximal humerus was the only individual fracture site associated with diabetes. Diabetic retinopathy (10.3, 2.2-48.0), diabetes duration (for greater than or equal to 10 years duration; 11.4, 2.4-54.2), and insulin treatment(18.8, 4.0-88.7) were all associated with proximal humerus fracture.CONCLUSIONS - These data suggest a significantly increased risk of fracture associated with diabetic retinopathy, advanced cortical cataract, longer diabetes duration, and insulin treatment. However, there are some shortcomings in this study that may limit these findings.