Starup-Linde Jakob, Gregersen Soeren, Vestergaard Peter
1 Clinical Institute, Aalborg University, Fredrik Bajers vej 5, 9220 Aalborg;
2 Department of Endocrinology and Internal Medicine (MEA), Aarhus University Hospital THG, Aarhus, Denmark;
J Clin Endocrinol Metab. 2014 Jan 16:jc20133558. doi: 10.1210/jc.2013-3558.
Diabetes Mellitus is associated with an increased risk of fractures, which is not explained fully by bone mineral density and common risk factors. The aim of this study is to investigate the association of medication and biochemical markers on the risk of fracture in a diabetes population.
Nested case-control study based on Danish diabetes patients from The Danish National Hospital Discharge Registry. The cases of the study were diabetes patients with a fracture (n= 24,349) and controls were diabetes patients with no fracture (n=132,349). A total of 2,816 diabetes patients were available for an analysis of patient characteristics, co-morbidities, biochemical parameters and drug usage.
Patient age at the time of diabetes diagnosis, a diagnosis of previous fracture, an alcohol related diagnosis, total cholesterol level, and the usage of antidepressants, antiepileptics and insulin all increased the odds of fracture. Low-density lipoprotein cholesterol (LDL) levels decreased the odds of fracture, where the level of 3.04-5.96 mmol/l was optimal with regard to fracture risk.
LDL may add to the understanding of fractures in diabetes patients and it may be added to current fracture risk models in diabetes patients.
糖尿病与骨折风险增加相关，而骨密度和常见风险因素并不能完全解释这一现象。本研究旨在调查药物和生化标志物与糖尿病患者骨折风险之间的关联。
基于丹麦国家医院出院登记处的丹麦糖尿病患者进行巢式病例对照研究。研究病例为发生骨折的糖尿病患者（n = 24,349），对照为未发生骨折的糖尿病患者（n = 132,349）。共有2816名糖尿病患者可用于分析患者特征、合并症、生化参数和药物使用情况。
糖尿病诊断时的患者年龄、既往骨折诊断、酒精相关诊断、总胆固醇水平以及抗抑郁药、抗癫痫药和胰岛素的使用均增加了骨折几率。低密度脂蛋白胆固醇（LDL）水平降低了骨折几率，就骨折风险而言，3.04 - 5.96 mmol/l的水平最为理想。
LDL可能有助于加深对糖尿病患者骨折情况的理解，并且可能被纳入当前糖尿病患者的骨折风险模型中。
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