SingHealth Polyclinics, 167 Jalan Bukit Merah, Connection One (Tower 5), #15-10, Singapore, 150167, Singapore.
SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore.
Arch Osteoporos. 2024 Sep 5;19(1):83. doi: 10.1007/s11657-024-01442-y.
This study investigated osteoporosis risk factors among older Asian men with type-2 diabetes mellitus, hypertension, or hyperlipidaemia in primary care. Advanced age, dementia, depression, and polypharmacy were associated with higher risks for osteoporosis. Screening strategies targeting these factors are crucial for improving bone health as part of comprehensive preventive care.
Asian patients with type-2 diabetes mellitus (T2DM), hypertension, or hyperlipidaemia (DHL) are predominantly managed in primary care. They are also at risk of osteoporosis, but men are often under-screened and under-treated for this preventable bone disorder. This study aimed to identify the clinical characteristics and risk factors of osteoporosis among older men with DHL in primary care for early intervention.
This retrospective study included men aged 65 years and older managed in public primary care clinics for their DHL between 1st July 2017 and 30th June 2018. Demographic, clinical, laboratory, and imaging data were extracted from their electronic medical records based on their International Classification of Diseases-10 (ICD-10) diagnosis codes. Descriptive statistical analyses, with statistical significance set at p < 0.05, were conducted, followed by generalized estimating equation (GEE) modelling.
Medical records of 17,644 men (83.1% Chinese, 16.9% minority ethnic groups, median age 71 years) were analysed. 2.3% of them had diagnosis of osteoporosis, 0.15% had fragility fracture, and 26.0% of those diagnosed with osteoporosis were treated with bisphosphonates. Their mean HbA1c was 6.9%; mean systolic and diastolic blood pressure were 133 and 69 mmHg. The GEE model showed that age (OR = 1.07, 95%CI = 1.05-1.09, p < 0.001), dementia (OR = 2.24, 95%CI = 1.33-3.77, p = 0.002), depression (OR = 2.38, 95%CI = 1.03-5.50, p = 0.043), and polypharmacy (OR = 6.85, 95%CI = 3.07-15.26, p < 0.001) were significantly associated with higher risks for osteoporosis.
Age, dementia, depression, and polypharmacy are associated with osteoporosis risks in men with DHL. Strategies to incorporate osteoporosis screening among older men with these risk factors are needed to improve their bone health.
亚洲 2 型糖尿病（T2DM）、高血压或血脂异常（DHL）患者主要在初级保健中接受管理。他们也有患骨质疏松症的风险，但男性往往因这种可预防的骨骼疾病而接受的筛查和治疗不足。本研究旨在确定初级保健中老年男性 DHL 患者骨质疏松症的临床特征和危险因素，以便进行早期干预。
本回顾性研究纳入了 2017 年 7 月 1 日至 2018 年 6 月 30 日期间在公立初级保健诊所因 DHL 接受治疗的年龄在 65 岁及以上的男性患者。根据他们的国际疾病分类第 10 版（ICD-10）诊断代码，从他们的电子病历中提取人口统计学、临床、实验室和影像学数据。进行描述性统计分析，统计学意义设为 p<0.05，然后进行广义估计方程（GEE）建模。
共分析了 17644 名男性患者（83.1%为华人，16.9%为少数民族，中位年龄为 71 岁）的病历。其中 2.3%被诊断为骨质疏松症，0.15%发生脆性骨折，26.0%被诊断为骨质疏松症的患者接受了双膦酸盐治疗。他们的平均糖化血红蛋白为 6.9%；平均收缩压和舒张压分别为 133 和 69mmHg。GEE 模型显示，年龄（OR=1.07，95%CI=1.05-1.09，p<0.001）、痴呆（OR=2.24，95%CI=1.33-3.77，p=0.002）、抑郁（OR=2.38，95%CI=1.03-5.50，p=0.043）和多药治疗（OR=6.85，95%CI=3.07-15.26，p<0.001）与骨质疏松症风险显著相关。
年龄、痴呆、抑郁和多药治疗与 DHL 男性的骨质疏松症风险相关。需要制定策略，将骨质疏松症筛查纳入具有这些危险因素的老年男性，以改善他们的骨骼健康。
