Vertebral Fractures in Individuals With Type 2 Diabetes: More Than Skeletal Complications Alone.

Koromani, Fjorda; Oei, Ling; Shevroja, Enisa; Trajanoska, Katerina; Schoufour, Josje; Muka, Taulant; Franco, Oscar H; Ikram, M Arfan; Zillikens, M Carola; Uitterlinden, André G; Krestin, Gabriel P; Anastassiades, Tassos; Josse, Robert; Kaiser, Stephanie M; Goltzman, David; Lentle, Brian C; Prior, Jerilynn C; Leslie, William D; McCloskey, Eugene; Lamy, Olivier; ... (2020). Vertebral Fractures in Individuals With Type 2 Diabetes: More Than Skeletal Complications Alone. Diabetes care, 43(1), pp. 137-144. American Diabetes Association 10.2337/dc19-0925

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OBJECTIVE We aimed to assess whether individuals with type 2 diabetes (T2D) have increased risk of vertebral fractures (VFs) and to estimate nonvertebral fracture and mortality risk among individuals with both prevalent T2D and VFs. RESEARCH DESIGN AND METHODS A systematic PubMed search was performed to identify studies that investigated the relationship between T2D and VFs. Cohorts providing individual-participant data (IPD) were also included. Estimates from published summary data and IPD cohorts were pooled in a random-effects meta-analysis. Multivariate Cox-regression models were used to estimate nonvertebral fracture and mortality risk among individuals with T2D and VFs. RESULTS Across 15 studies comprising 852,705 men and women, individuals with T2D had lower risk of prevalent (odds ratio [OR] 0.84 [95% CI 0.74-0.95]; I 2 = 0.0%; Phet = 0.54) but increased risk of incident VFs (OR 1.35 [95% CI 1.27-1.44]; I 2 = 0.6%; Phet = 0.43). In the IPD cohorts (N = 19,820), risk of nonvertebral fractures was higher in those with both T2D and VFs compared with those without T2D or VFs (hazard ratio [HR] 2.42 [95% CI 1.86-3.15]), with VFs (HR 1.73 [95% CI 1.32-2.27]), or T2D (HR 1.94 [95% CI 1.46-2.59]) alone. Individuals with both T2D and VFs had increased mortality compared with individuals without T2D and VFs (HR 2.11 [95% CI 1.72-2.59]) or with VFs alone (HR 1.84 [95% CI 1.49-2.28]) and borderline increased compared with individuals with T2D alone (HR 1.23 [95% CI 0.99-1.52]). CONCLUSIONS Based on our findings, individuals with T2D should be systematically assessed for presence of VFs, and, as in individuals without T2D, their presence constitutes an indication to start osteoporosis treatment for the prevention of future fractures.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Muka, Taulant and Franco Duran, Oscar Horacio

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0149-5992

Publisher:

American Diabetes Association

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

06 Nov 2019 16:20

Last Modified:

23 Dec 2019 01:32

Publisher DOI:

10.2337/dc19-0925

PubMed ID:

31658976

BORIS DOI:

10.7892/boris.134656

URI:

https://boris.unibe.ch/id/eprint/134656

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