Yokomoto-Umakoshi Maki, Kanazawa Ippei, Kondo Shiori, Sugimoto Toshitsugu
Internal Medicine 1, Shimane University Faculty of Medicine, Izumo 693-8501, Japan.
Department of Medicine, Diabetes, Metabolism and Endocrinology, Matsuyama Red Cross Hospital, Matsuyama 790-8524, Japan.
Endocr J. 2017 Jul 28;64(7):727-734. doi: 10.1507/endocrj.EJ17-0011. Epub 2017 May 19.
Diabetes mellitus is associated with an increased risk of falls, which increases the incidence of osteoporotic fractures and accordingly decreases quality of life. However, the association between fall risk and diabetic complications is not completely understood. Therefore, the aim of this study was to examine the association between fall risk and osteoporotic fractures in patients with type 2 diabetes mellitus (T2DM). We enrolled 194 Japanese patients with T2DM and assessed their fall risk using a brief interview form that included five items covering physical and social aspects of functioning and environmental factors. We examined the associations between fall risk and the presence of diabetic complications, such as neuropathy, retinopathy, nephropathy, cardiovascular disease, cerebrovascular disease, peripheral artery disease (PAD), and osteoporotic fractures (including any fracture and vertebral fractures only). In the multivariate logistic regression analysis, a longer history of T2DM, the presence of neuropathy and PAD, and a history of any fractures were significantly and positively associated with the risk of falls. On the other hand, a lower body mass index, the presence of neuropathy, and the risk of falls were independently and positively associated with the risk of any fracture. When fractures were limited to vertebral fractures only, the association with the risk of falls remained significant. We found that the risk of falls and osteoporotic fractures were associated in patients with T2DM and that a brief screening test of the risk of falls was useful for assessing the risk of osteoporotic fractures.
糖尿病与跌倒风险增加相关,这会增加骨质疏松性骨折的发生率,进而降低生活质量。然而,跌倒风险与糖尿病并发症之间的关联尚未完全明确。因此,本研究的目的是探讨2型糖尿病(T2DM)患者跌倒风险与骨质疏松性骨折之间的关联。我们纳入了194例日本T2DM患者,并使用一份简短的访谈表格评估他们的跌倒风险,该表格包含涵盖功能的身体和社会方面以及环境因素的五个项目。我们研究了跌倒风险与糖尿病并发症(如神经病变、视网膜病变、肾病、心血管疾病、脑血管疾病、外周动脉疾病(PAD))以及骨质疏松性骨折(包括任何骨折和仅椎体骨折)之间的关联。在多因素逻辑回归分析中,T2DM病程较长、存在神经病变和PAD以及有任何骨折史与跌倒风险显著正相关。另一方面,较低的体重指数、存在神经病变以及跌倒风险与任何骨折的风险独立且正相关。当骨折仅限于椎体骨折时,其与跌倒风险的关联仍然显著。我们发现T2DM患者的跌倒风险与骨质疏松性骨折相关,并且对跌倒风险进行简短筛查测试有助于评估骨质疏松性骨折的风险。