Fracture risk in women with type II diabetes. Results from a historical cohort with fracture follow-up
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ORIGINAL ARTICLE
Fracture risk in women with type II diabetes. Results from a historical cohort with fracture follow-up Jakob Præst Holm
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Thomas Jensen1 Lars Hyldstrup1 Jens-Erik Beck Jensen1 ●
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Received: 24 September 2017 / Accepted: 5 February 2018 © Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract Purpose To examine the independent association between type II diabetes and fracture risk in a population of predominantly postmenopausal women referred to a specialist clinic for osteoporosis evaluation. Methods Type II diabetes associated fracture risk were evaluated among to 229 patients with type II diabetes in a cohort of 6285 women followed on average (until major osteoporotic fracture (MOF), death or end of study) for 5.8 years. Information of fracture risk factors was obtained from a clinical database and from national registries. Results An elevated fracture risk was present. Prevalent fractures (43.7 vs. 33.2%, p = 0.0010) and prevalent MOF (26.2 vs. 20.5% p = 0.038) were more common among patients with type II diabetes. The unadjusted incident fracture risk was increased with a higher relative risk of 42%. An elevated MOF hazard ratio was present (HR = 1.726, p = 0.0006). Adjustment for prevalent osteoporosis and other possible confounders did not change this finding (HR = 1.558, p = 0.0207). Conclusions An association between type II diabetes and an increased risk of MOF primarily driven by an increased hip fracture risk was documented. This finding was independent of the presence of osteoporosis. Clinicians need to be aware of and adjust for these findings when evaluating patients with diabetes. Additional research examining pathophysiological mechanisms are needed. Keywords Fracture risk Type II diabetes Women’s health Osteoporosis Secondary osteoporosis ●
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Background and introduction Type II diabetes is a chronic, metabolic disease characterized by high blood glucose caused by insulin resistance. Type II diabetes is affecting an increasing proportion of individuals all over the world with numbers estimated to around 285 million worldwide and with a major expected increase in the prevalence in the years to come [1]. The disease leads to a wide range of complications. As such complications attributable to neuropathy, nephropathy, and retinopathy are common [2]. Although the most serious consequence of type II diabetes is the observed elevated risk
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12020-018-1564-x) contains supplementary material, which is available to authorized users. * Jakob Præst Holm [email protected] 1
Department of Endocrinology, Copenhagen University Hospital Hvidovre, Kettegaards Allé 30, Hvidovre DK-2650, Denmark
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of cardiovascular disease a long list of other comorbid conditions can cause considerable morbidity and reduced quality of life [2]. In recent years increasing evidence that an elevated susceptibility to fractures should be considered a complication of diabetes t
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