Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Division of Internal Medicine, Fukuoka Dental College, Fukuoka, Japan.
J Diabetes Investig. 2020 Jan;11(1):62-69. doi: 10.1111/jdi.13076. Epub 2019 Jun 12.
AIMS/INTRODUCTION: Patients with type 2 diabetes mellitus have an increased hip fracture risk. We investigated the relationship between hip fracture and all-cause death in patients with type 2 diabetes in comparison with cardiovascular disease (CVD) or end-stage renal disease (ERSD).
In total, 4,923 Japanese participants with type 2 diabetes (mean age 65 years, 2,790 men, 2,133 women) were followed for a median of 5.3 years (follow-up rate 99.5%). We evaluated the associations between the presence of hip fracture (n = 110), upper limb fracture (n = 801), CVD (n = 1,344), ESRD (n = 104) and all-cause death by logistic regression analysis.
A total of 309 participants died during follow up. Multivariate-adjusted odds ratios (ORs) for all-cause mortality were significantly higher in participants with hip fractures than those without hip fractures (OR 2.67, 95% confidence interval [CI] 1.54-4.41), whereas the ORs for upper limb fracture were not significant. The ORs for all-cause mortality were significantly higher in participants with CVD than those without CVD (OR 1.78, 95% CI, 1.39-2.70) and ESRD (OR 2.36, 95% CI 1.32-4.05). The ORs for all-cause mortality of hip fracture were not affected by further adjustment for CVD and ESRD (OR 2.74, 95% CI 1.58-4.54). The cause of death was infection (40.0%), malignant neoplasm (25.0%) and CVD (15.0%) among participants with hip fracture.
Hip fractures were associated with an increased risk of death among Japanese patients with type 2 diabetes, independently of CVD and ESRD.
目的/引言：2 型糖尿病患者髋部骨折风险增加。我们比较了 2 型糖尿病患者髋部骨折与心血管疾病（CVD）或终末期肾病（ESRD）与全因死亡的关系。
共有 4923 名日本 2 型糖尿病患者（平均年龄 65 岁，男性 2790 名，女性 2133 名）接受了中位 5.3 年的随访（随访率为 99.5%）。我们通过 logistic 回归分析评估了髋部骨折（n=110）、上肢骨折（n=801）、CVD（n=1344）和 ESRD（n=104）的存在与全因死亡之间的关联。
共有 309 名参与者在随访期间死亡。多变量校正后的全因死亡率比值比（OR）髋部骨折组明显高于无髋部骨折组（OR 2.67，95%置信区间 [CI] 1.54-4.41），而上肢骨折组则不明显。CVD 组的全因死亡率 OR 高于无 CVD 组（OR 1.78，95%CI，1.39-2.70）和 ESRD 组（OR 2.36，95%CI 1.32-4.05）。进一步调整 CVD 和 ESRD 后，髋部骨折的全因死亡率 OR（OR 2.74，95%CI 1.58-4.54）并未受影响。髋部骨折患者的死亡原因分别为感染（40.0%）、恶性肿瘤（25.0%）和 CVD（15.0%）。
日本 2 型糖尿病患者髋部骨折与死亡风险增加相关，与 CVD 和 ESRD 无关。
