PMID- 29502187
OWN - NLM
STAT- MEDLINE
DCOM- 20190510
LR  - 20190510
IS  - 1862-3514 (Electronic)
VI  - 13
IP  - 1
DP  - 2018 Mar 3
TI  - Epidemiology and correlates of osteoporotic fractures among type 2 diabetic 
      patients.
PG  - 15
LID - 10.1007/s11657-018-0432-x [doi]
AB  - This study analyzed data on 87,224 osteoporotic patients with up to 18 years of 
      computerized medical history. Patients with osteoporosis and type 2 diabetes had 
      higher bone density yet more fractures than non-diabetic osteoporotic patients. 
      Fracture incidence among the diabetic patients was associated with retinopathy 
      and cardiovascular disease, but not with diabetes duration. PURPOSE: Little is 
      known about the association between type 2 diabetes mellitus (T2DM) and fragility 
      fractures or the mechanism(s) involved. We examined fracture correlates among 
      T2DM patients with osteoporosis. METHODS: We used electronic health records of an 
      osteoporosis (OP) registry cross-linked with a diabetes registry of a large payer 
      provider healthcare organization in Israel. A cross-sectional analysis compared 
      osteoporosis patients with and without T2DM, and a longitudinal Cox proportional 
      hazard regression was used to identify incident fracture correlates. RESULTS: As 
      of December 2015 a total of 87,224 current OP patients were identified, of whom 
      15,700 (18%) had T2DM. The T2DM OP patients were characterized by older age (mean 
      74.6 vs. 69.5), more males (20.3 vs. 14.0%), and a higher rate of chronic 
      comorbidities compared to OP without diabetes. All major OP fractures (hip, 
      spine, humerus, and forearm) were significantly more prevalent among T2DM OP 
      patients (44 vs. 32%), with an overall age-standardized ratio of 1.22 (95% CI 
      1.19 to 1.25) and 1.15 (95% CI 1.10 to 1.21) for females and males respectively. 
      The average T-scores were higher (femur neck - 1.8 vs. - 1.9, total hip - 1.2 vs. 
      - 1.6, and vertebrae - 1.3 vs. - 1.7) for the T2DM OP patients compared to the 
      non-T2DM OP patients. Among women with coexisting T2DM and osteoporosis 
      (n = 10,812), fracture incidence was significantly associated with retinopathy 
      (HR = 1.24, 95% CI 1.05 to 1.47) and cardiovascular disease (HR = 1.22, 95% CI 
      1.10 to 1.36) after controlling for age, bone mineral density T-score, rheumatoid 
      arthritis, glucocorticoids, alcohol, and smoking). CONCLUSION: This large 
      population-based study confirms the higher fracture risk of osteoporotic patients 
      with T2DM, as compared to osteoporotic patients without T2DM, despite higher bone 
      mineral density levels. The presence of micro- and macrovascular disease appears 
      to increase this risk.
FAU - Goldshtein, Inbal
AU  - Goldshtein I
AD  - Epidemiology & Database Research Unit, Maccabi Healthcare Services, Koyfman 4, 
      Tel Aviv, Israel. goldst_in@mac.org.il.
FAU - Nguyen, Allison Martin
AU  - Nguyen AM
AD  - Merck & Co Inc., North Wales, PA, USA.
FAU - dePapp, Anne E
AU  - dePapp AE
AD  - Merck & Co Inc., North Wales, PA, USA.
FAU - Ish-Shalom, Sofia
AU  - Ish-Shalom S
AD  - Endocrine Clinic, Elisha Hospital, Haifa, Israel.
FAU - Chandler, Julie M
AU  - Chandler JM
AD  - Merck & Co Inc., North Wales, PA, USA.
FAU - Chodick, Gabriel
AU  - Chodick G
AD  - Epidemiology & Database Research Unit, Maccabi Healthcare Services, Koyfman 4, 
      Tel Aviv, Israel.
FAU - Shalev, Varda
AU  - Shalev V
AD  - Epidemiology & Database Research Unit, Maccabi Healthcare Services, Koyfman 4, 
      Tel Aviv, Israel.
LA  - eng
PT  - Journal Article
DEP - 20180303
PL  - England
TA  - Arch Osteoporos
JT  - Archives of osteoporosis
JID - 101318988
SB  - IM
MH  - Aged
MH  - Bone Density
MH  - Comorbidity
MH  - Cross-Sectional Studies
MH  - *Diabetes Mellitus, Type 2/diagnosis/epidemiology/metabolism
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Israel/epidemiology
MH  - Male
MH  - Middle Aged
MH  - *Osteoporosis/diagnosis/epidemiology/metabolism
MH  - *Osteoporotic Fractures/classification/diagnosis/epidemiology/metabolism
MH  - Prevalence
MH  - Registries/statistics & numerical data
MH  - Risk Factors
OTO - NOTNLM
OT  - Complications
OT  - Fracture
OT  - Osteoporosis
OT  - Type 2 diabetes mellitus
EDAT- 2018/03/05 06:00
MHDA- 2019/05/11 06:00
CRDT- 2018/03/05 06:00
PHST- 2017/08/07 00:00 [received]
PHST- 2018/02/04 00:00 [accepted]
PHST- 2018/03/05 06:00 [entrez]
PHST- 2018/03/05 06:00 [pubmed]
PHST- 2019/05/11 06:00 [medline]
AID - 10.1007/s11657-018-0432-x [pii]
AID - 10.1007/s11657-018-0432-x [doi]
PST - epublish
SO  - Arch Osteoporos. 2018 Mar 3;13(1):15. doi: 10.1007/s11657-018-0432-x.