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The incidence of fractures at various sites in newly treated patients with type 2 diabetes mellitus
PURPOSE: In this descriptive study, we examined the incidence of fractures in patients with newly treated type 2 diabetes mellitus (T2D) compared to matched reference population. METHODS: Participants from the UK Clinical Practice research datalink (CPRD) GOLD (1987–2017), aged ≥30 years, with a T2D...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9437792/ https://www.ncbi.nlm.nih.gov/pubmed/36062034 http://dx.doi.org/10.1016/j.bonr.2022.101614 |
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author | Sarodnik, Cindy Rasmussen, Nicklas H. Bours, Sandrine P.G. Schaper, Nicolaas C. Vestergaard, Peter Souverein, Patrick C. Jensen, Morten H. Driessen, Johanna H.M. van den Bergh, Joop P.W. |
author_facet | Sarodnik, Cindy Rasmussen, Nicklas H. Bours, Sandrine P.G. Schaper, Nicolaas C. Vestergaard, Peter Souverein, Patrick C. Jensen, Morten H. Driessen, Johanna H.M. van den Bergh, Joop P.W. |
author_sort | Sarodnik, Cindy |
collection | PubMed |
description | PURPOSE: In this descriptive study, we examined the incidence of fractures in patients with newly treated type 2 diabetes mellitus (T2D) compared to matched reference population. METHODS: Participants from the UK Clinical Practice research datalink (CPRD) GOLD (1987–2017), aged ≥30 years, with a T2D diagnosis code and a first prescription for a non-insulin anti-diabetic drug (n = 124,328) were included. Cases with T2D were matched by year of birth, sex and practice to a reference population (n = 124,328), the mean follow-up was 7.7 years. Crude fracture incidence rates (IRs) and incidence rate ratios (IRRs) were calculated. Analyses were stratified by fracture site and sex and additionally adjusted for BMI, smoking status, alcohol use and history of any fracture at index date. RESULTS: The IR of all fractures and major osteoporotic fractures was lower in T2D compared to the reference population (IRR 0.97; 95%CI 0.94–0.99). The IRs were lower for clavicle (IRR 0.67; 0.56–0.80), radius/ulna (IRR 0.81; 0.75–0.86) and vertebral fractures (0.83; 0.75–0.92) and higher for ankle (IRR 1.16; 95%CI 1.06–1.28), foot (1.11; 1.01–1.22), tibia/fibula (1.17; 1.03–1.32) and humerus fractures (1.11; 1.03–1.20). Differences in IRs at various fracture sites between T2D and the reference population were more pronounced in women than in men. In contrast, BMI adjusted IRs for all fractures (IRR 1.07; 1.04–1.10) and most individual fracture sites were significantly higher in T2D, especially in women. CONCLUSION: The crude incidence of all fractures was marginally lower in patients with newly treated T2D compared to the matched reference population but differed according to fracture site, especially in women. BMI adjusted analyses resulted in higher incidence rates in T2D at almost all fracture sites compared to crude incidence rates and this was more pronounced in women than in men. This implies that BMI may have a protective impact on the crude incidence of fractures, especially in women with newly treated T2D. |
format | Online Article Text |
id | pubmed-9437792 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-94377922022-09-03 The incidence of fractures at various sites in newly treated patients with type 2 diabetes mellitus Sarodnik, Cindy Rasmussen, Nicklas H. Bours, Sandrine P.G. Schaper, Nicolaas C. Vestergaard, Peter Souverein, Patrick C. Jensen, Morten H. Driessen, Johanna H.M. van den Bergh, Joop P.W. Bone Rep Full Length Article PURPOSE: In this descriptive study, we examined the incidence of fractures in patients with newly treated type 2 diabetes mellitus (T2D) compared to matched reference population. METHODS: Participants from the UK Clinical Practice research datalink (CPRD) GOLD (1987–2017), aged ≥30 years, with a T2D diagnosis code and a first prescription for a non-insulin anti-diabetic drug (n = 124,328) were included. Cases with T2D were matched by year of birth, sex and practice to a reference population (n = 124,328), the mean follow-up was 7.7 years. Crude fracture incidence rates (IRs) and incidence rate ratios (IRRs) were calculated. Analyses were stratified by fracture site and sex and additionally adjusted for BMI, smoking status, alcohol use and history of any fracture at index date. RESULTS: The IR of all fractures and major osteoporotic fractures was lower in T2D compared to the reference population (IRR 0.97; 95%CI 0.94–0.99). The IRs were lower for clavicle (IRR 0.67; 0.56–0.80), radius/ulna (IRR 0.81; 0.75–0.86) and vertebral fractures (0.83; 0.75–0.92) and higher for ankle (IRR 1.16; 95%CI 1.06–1.28), foot (1.11; 1.01–1.22), tibia/fibula (1.17; 1.03–1.32) and humerus fractures (1.11; 1.03–1.20). Differences in IRs at various fracture sites between T2D and the reference population were more pronounced in women than in men. In contrast, BMI adjusted IRs for all fractures (IRR 1.07; 1.04–1.10) and most individual fracture sites were significantly higher in T2D, especially in women. CONCLUSION: The crude incidence of all fractures was marginally lower in patients with newly treated T2D compared to the matched reference population but differed according to fracture site, especially in women. BMI adjusted analyses resulted in higher incidence rates in T2D at almost all fracture sites compared to crude incidence rates and this was more pronounced in women than in men. This implies that BMI may have a protective impact on the crude incidence of fractures, especially in women with newly treated T2D. Elsevier 2022-08-22 /pmc/articles/PMC9437792/ /pubmed/36062034 http://dx.doi.org/10.1016/j.bonr.2022.101614 Text en © 2022 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Full Length Article Sarodnik, Cindy Rasmussen, Nicklas H. Bours, Sandrine P.G. Schaper, Nicolaas C. Vestergaard, Peter Souverein, Patrick C. Jensen, Morten H. Driessen, Johanna H.M. van den Bergh, Joop P.W. The incidence of fractures at various sites in newly treated patients with type 2 diabetes mellitus |
title | The incidence of fractures at various sites in newly treated patients with type 2 diabetes mellitus |
title_full | The incidence of fractures at various sites in newly treated patients with type 2 diabetes mellitus |
title_fullStr | The incidence of fractures at various sites in newly treated patients with type 2 diabetes mellitus |
title_full_unstemmed | The incidence of fractures at various sites in newly treated patients with type 2 diabetes mellitus |
title_short | The incidence of fractures at various sites in newly treated patients with type 2 diabetes mellitus |
title_sort | incidence of fractures at various sites in newly treated patients with type 2 diabetes mellitus |
topic | Full Length Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9437792/ https://www.ncbi.nlm.nih.gov/pubmed/36062034 http://dx.doi.org/10.1016/j.bonr.2022.101614 |
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