Risk of fracture in women with type 2 diabetes: The Women's Health Initiative Observational Study
Risk of fracture in women with type 2 diabetes: The Women's Health Initiative Observational Study
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DOI：
10.1210/jc.2006-0614
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发表时间：
2006-09-01
影响因子：
5.8
通讯作者：
Margolis, Karen L.
中科院分区：
文献类型：
--
作者：
Bonds, Denise E.;Larson, Joseph C.;Margolis, Karen L.
内容：一些但不是所有的研究表明2型糖尿病患者骨折的发生率更高。目的：本研究的目的是确定绝经后2型糖尿病女性骨折的风险，并确定骨折部位、种族和基线骨密度是否会改变骨折风险。设计、设置和参与者：妇女健康倡议观察队列中基线时临床诊断为2型糖尿病的妇女，一项针对绝经后妇女的前瞻性研究（n = 93，676）与未诊断糖尿病的女性进行比较，并确定了总体和特定部位的骨折风险。主要结果指标：所有骨折和特定部位分别（髋/骨盆/大腿;小腿/踝/膝;脚;上臂/肩/肘;下臂/腕/手;脊柱/尾骨）进行测量。结果：在控制了包括福尔斯频率在内的多个危险因素后，糖尿病女性在基线时7年随访后骨折的总体风险较高[校正相对危险度（RR）1.20，95%可信区间（CI）1.11 - 1.30]。在具有基线BMD评分的女性子样本中，糖尿病女性的髋部和脊柱BMD更高。黑人女性（RR 1.33，95%CI 1.00 - 1.75）和基线骨密度增加的女性（RR 1.26，95%CI 0.96 - 1.66）多部位（髋部/骨盆/大腿;足部;脊柱/尾骨）骨折风险增加。在调整了包括频繁福尔斯和BMD增加（在一个子集中）在内的多种风险因素后，这种风险也见于黑人和非西班牙裔白色女性。
Context: Some but not all studies have shown higher rates of fracture in individuals with type 2 diabetes.Objective: The objective of the study was to determine the risk of fracture in postmenopausal women with type 2 diabetes and determine whether risk varies by fracture site, ethnicity, and baseline bone density.Design, Setting, and Participants: Women with clinically diagnosed type 2 diabetes at baseline in the Women's Health Initiative Observational Cohort, a prospective study of postmenopausal women (n = 93,676), were compared with women without diagnosed diabetes and risk of fracture overall and at specific sites determined.Main Outcome Measures: All fractures and specific sites separately (hip/pelvis/upper leg; lower leg/ankle/knee; foot; upper arm/shoulder/elbow; lower arm/wrist/hand; spine/tailbone) were measured. Bone mineral density (BMD) in a subset also was measured.Results: The overall risk of fracture after 7 yr of follow-up was higher in women with diabetes at baseline after controlling for multiple risk factors including frequency of falls [ adjusted relative risk (RR) 1.20, 95% confidence interval (CI) 1.11 - 1.30]. In a subsample of women with baseline BMD scores, women with diabetes had greater hip and spine BMD. The elevated fracture risk was found at multiple sites (hip/pelvis/upper leg; foot; spine/tailbone) among black women (RR 1.33, 95% CI 1.00 - 1.75) and women with increased baseline bone density (RR 1.26, 95% CI 0.96 - 1.66).Conclusion: Women with type 2 diabetes are at increased risk for fractures. This risk is also seen among black and non-Hispanic white women after adjustment for multiple risk factors including frequent falls and increasedBMD(in a subset).