PMID- 34333678 OWN - NLM STAT- MEDLINE DCOM- 20211124 LR - 20220505 IS - 1433-2965 (Electronic) IS - 0937-941X (Linking) VI - 32 IP - 12 DP - 2021 Dec TI - Comparison of fracture risk between type 1 and type 2 diabetes: a comprehensive real-world data. PG - 2543-2553 LID - 10.1007/s00198-021-06032-z [doi] AB - Population-based cohort study of 6,548,784 Korean subjects demonstrates that the risk of fracture was higher in patients with diabetes than in nondiabetic subjects. Furthermore, patients with type 1 diabetes were associated with a higher risk of fracture than patients with type 2 diabetes for all measurement sites. INTRODUCTION: Diabetes mellitus is associated with increased fracture risk. Although the pathophysiologic effect on bone metabolism differs according to the type of diabetes, a higher risk of fracture in patients with diabetes than in nondiabetic patients has been consistently demonstrated. Considering the ever-increasing number of patients with diabetes, we aimed to provide updated information on whether this phenomenon remains valid in real-world settings by using large-scale population datasets. METHODS: We conducted a retrospective longitudinal study using data from the Korean National Health Insurance Service dataset of preventive health check-ups between January 2009 and December 2016. The hazard ratios were calculated for any fracture, vertebral fracture, and hip fracture and were analyzed according to the presence and type of diabetes. Among 10,585,818 subjects, 6,548,784 were eligible for the analysis (2418 patients with type 1 diabetes mellitus [T1DM] and 506,208 patients with type 2 diabetes mellitus [T2DM]). RESULTS: The mean follow-up duration (in years) was 7.0 +/- 1.3 for subjects without diabetes, 6.4 +/- 2.0 for those with T1DM, and 6.7 +/- 1.7 for T2DM. Patients with T1DM had a higher incidence rate for all types of fractures per 1000 person-years. The fully adjusted hazard ratios (HRs) for any fracture, vertebral fracture, and hip fracture were higher in T1DM than in T2DM (1.37 [95% confidence interval (CI): 1.23-1.52] for any fracture, 1.33 [95% CI: 1.09-1.63] for vertebral fracture, and 1.99 [95% CI: 1.56-2.53] for hip fracture). CONCLUSIONS: In this large-scale population analysis, diabetes was associated with a higher risk of all types of fractures. Patients with T1DM had a higher risk of fracture than those with T2DM for all measurement sites, and hip fractures had the highest risk. Therefore, fracture prevention training for patients with diabetes is advisable. CI - (c) 2021. International Osteoporosis Foundation and National Osteoporosis Foundation. FAU - Ha, J AU - Ha J AD - Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Jeong, C AU - Jeong C AD - Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Han, K-D AU - Han KD AD - Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea. FAU - Lim, Y AU - Lim Y AD - Division of General Internal Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. FAU - Kim, M K AU - Kim MK AD - Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Kwon, H-S AU - Kwon HS AD - Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Song, K-H AU - Song KH AD - Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Kang, M I AU - Kang MI AD - Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Baek, K-H AU - Baek KH AUID- ORCID: 0000-0002-4097-1077 AD - Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. drbkh@catholic.ac.kr. LA - eng PT - Journal Article DEP - 20210731 PL - England TA - Osteoporos Int JT - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JID - 9100105 SB - IM CIN - Osteoporos Int. 2022 Apr;33(4):955-956. PMID: 35175393 CIN - Osteoporos Int. 2022 Apr;33(4):953-954. PMID: 35175394 MH - Cohort Studies MH - *Diabetes Mellitus, Type 1/complications/epidemiology MH - *Diabetes Mellitus, Type 2/complications/epidemiology MH - *Hip Fractures/epidemiology/etiology MH - Humans MH - Longitudinal Studies MH - Retrospective Studies MH - Risk Factors OTO - NOTNLM OT - Diabetes mellitus OT - Hip fractures OT - Spinal fractures EDAT- 2021/08/02 06:00 MHDA- 2021/11/25 06:00 CRDT- 2021/08/01 21:13 PHST- 2021/02/03 00:00 [received] PHST- 2021/06/11 00:00 [accepted] PHST- 2021/08/02 06:00 [pubmed] PHST- 2021/11/25 06:00 [medline] PHST- 2021/08/01 21:13 [entrez] AID - 10.1007/s00198-021-06032-z [pii] AID - 10.1007/s00198-021-06032-z [doi] PST - ppublish SO - Osteoporos Int. 2021 Dec;32(12):2543-2553. doi: 10.1007/s00198-021-06032-z. Epub 2021 Jul 31.