The risk of hip fractures in older individuals with diabetes - A population-based study
The risk of hip fractures in older individuals with diabetes - A population-based study
复制标题
DOI：
10.2337/dc06-1851
复制
发表时间：
2007-04-01
期刊：
影响因子：
16.2
通讯作者：
Hawker, Gillian A.
中科院分区：
文献类型：
--
作者：
Lipscombe, Lorraine L.;Booth, Gillian L.;Hawker, Gillian A.
目的：与没有糖尿病的男性和女性相比，2型糖尿病患者的骨密度（BMD）更高。然而，他们髋部骨折的风险可能会增加。使用基于人群的安大略省卫生保健数据，我们比较了患有和不患有糖尿病的男性和女性髋部骨折的风险。研究设计和方法：采用回顾性队列设计，从1994年至1995年的有效登记中（n = 197,412）确定年龄为bb0 = 66岁的安大略省居民患有糖尿病，并随访他们的第一次髋部骨折至2003年3月31日（平均6.1年随访）。髋部骨折发生率与年龄匹配的无糖尿病安大略省居民（n = 401,400）进行比较，结果按性别分层，并根据年龄和其他协变量进行调整。结果：与非糖尿病患者相比，糖尿病患者有更多的合并症，更不可能进行骨密度测试，更有可能服用增加跌倒风险和降低骨密度的药物。在调整了这些差异和年龄后，我们发现糖尿病增加了男性和女性的骨折风险（风险比1.18 [95% Cl 1.12-1.24], P < 0.0001）和女性（风险比1.11 [1.08-1.15],P < 0.0001）。结论：与非糖尿病患者相比，患有糖尿病的男性和女性髋部骨折的风险更高。需要进一步的研究来阐明这种骨折风险增加的机制，并增加对糖尿病患者骨折预防策略的关注。
OBJECTIVE - Compared with men and women without diabetes, individuals with type 2 diabetes have higher bone mineral density (BMD). However, they may still be at increased risk for hip fractures. Using population-based Ontario health care data, we compared the risk of hip fractures among men and women with and without diabetes.RESEARCH DESIGN AND METHODS - Using a retrospective cohort design, we identified Ontario residents aged >= 66 years with diabetes from a validated registry from 1994 to 1995 (n = 197,412) and followed them for their first hip fracture until 31 March 2003 (mean 6.1-year follow-up). Hip fracture rates were compared with those of age-matched Ontario residents without diabetes (n = 401,400), and results were stratified by sex and adjusted for age and other covariates.RESULTS - Compared with individuals without diabetes, individuals with diabetes had greater comorbidity, were less likely to have had a BMD test, and were more likely to be taking medications that increase risk of falling and decrease BMD. After adjusting for these differences and age, we found that diabetes increased fracture risk in both men (hazard ratio 1.18 [95% Cl 1.12-1.24], P < 0.0001) and women (1.11 [1.08-1.15], P < 0.0001).CONCLUSIONS - Men and women with diabetes have a higher risk of hip fractures compared with individuals without diabetes. Further research to elucidate the mechanisms underlying this increased risk of fracture is needed, as well as increased attention to fracture prevention strategies in patients with diabetes.