Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Clinical Chemistry and Laboratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Diabetes Care. 2018 May;41(5):1061-1067. doi: 10.2337/dc17-2004. Epub 2018 Mar 14.
There is growing evidence that weight loss is associated with increased fracture risk in the general population. As patients with diabetes often lose weight intentionally or unintentionally, we aimed to investigate prospectively the relationship between weight loss from maximum body weight and fracture risk.
A total of 4,706 Japanese participants with type 2 diabetes (mean age 66 years), including 2,755 men and 1,951 postmenopausal women, were followed for a median of 5.3 years and were divided according to weight loss from maximum weight: <10%, 10% to <20%, 20% to <30%, and ≥30%. The primary outcomes were fragility fractures defined as fractures at sites of hip and spine.
During the follow-up period, fragility fractures occurred in 198 participants. The age- and sex-adjusted incidence rates per 1,000 person-years in all participants were 6.4 (<10% weight loss from maximum body weight), 7.8 (10% to <20%), 11.7 (20% to <30%), and 19.2 (≥30%) ( for trend <0.001). Multivariate-adjusted hazard ratios for fragility fractures compared with reference (<10% weight loss) were 1.48 (95% CI 0.79-2.77) in the 10% to <20% group, 2.23 (1.08-4.64) in 20% to <30%, and 5.20 (2.15-12.57) in ≥30% in men, and 1.19 (0.78-1.82) in 10% to <20%, 1.62 (0.96-2.73) in 20% to <30%, and 1.97 (0.84-4.62) in ≥30% in postmenopausal women.
The current study demonstrates that ≥20% body weight loss from maximum weight is a significant risk factor for fragility fractures in patients with type 2 diabetes, especially in men.
越来越多的证据表明，体重减轻与普通人群的骨折风险增加有关。由于糖尿病患者常常有意或无意地减轻体重，我们旨在前瞻性研究从最大体重减轻的体重与骨折风险之间的关系。
共有 4706 名日本 2 型糖尿病患者（平均年龄 66 岁），包括 2755 名男性和 1951 名绝经后女性，随访中位数为 5.3 年，并根据从最大体重减轻的体重进行分组：<10%、10%至<20%、20%至<30%和≥30%。主要结局是定义为髋部和脊柱部位骨折的脆性骨折。
在随访期间，198 名参与者发生了脆性骨折。所有参与者每 1000 人年的年龄和性别调整发生率分别为 6.4（体重减轻<10%从最大体重）、7.8（10%至<20%）、11.7（20%至<30%）和 19.2（≥30%）（趋势<0.001）。与参考值（体重减轻<10%）相比，脆性骨折的多变量调整后的危险比为 1.48（95%CI 0.79-2.77）在 10%至<20%组、2.23（1.08-4.64）在 20%至<30%组和 5.20（2.15-12.57）在≥30%组的男性中，1.19（0.78-1.82）在 10%至<20%组、1.62（0.96-2.73）在 20%至<30%组和 1.97（0.84-4.62）在≥30%组的绝经后女性中。
目前的研究表明，从最大体重减轻≥20%的体重是 2 型糖尿病患者脆性骨折的一个重要危险因素，尤其是男性。
