Guo Shao-Han, Xu Jian, Xu Min-Zhe, Li Chong, Gong Ya-Qin, Lu Ke
Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China.
Department of Orthopedics, The First People's Hospital of Kunshan, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China.
Front Med (Lausanne). 2024 Dec 17;11:1492603. doi: 10.3389/fmed.2024.1492603. eCollection 2024.
The relationship between diabetes mellitus (DM) and bone mineral density (BMD) in patients with osteoporotic fractures (OPFs) remains complex and heterogeneous, specifically between the genders. This study aimed to explore the association between diabetes status and trochanteric BMD in a cohort of patients with OPFs and elucidate the differences between male and female patients.
This retrospective analysis was performed on 710 admitted patients aged 50 years or older with OPFs. In this study, the exposure variable was diabetes status. Trochanteric BMD comprised the dependent variable. While controlling for covariance influences, generalized estimating equations (GEE) were applied to examine the independent link between diabetes status and trochanteric BMD in OPFs patients. Moreover, a subgroup analysis was also conducted to validate the result's stability.
A substantial positive association was noted between diabetes status and trochanteric BMD in diabetic patients, as determined by the fully adjusted model ( = 0.017, 95% CI 0.001 to 0.033, = 0.035). Furthermore, the sex-specific analysis showed a significant positive relationship between diabetes status and trochanteric BMD in male patients ( = 0.040, 95% CI 0.006 to 0.075, = 0.022), whereas no significant relationship was observed in female patients ( = 0.010, 95% CI -0.008 to 0.028, = 0.256).
This study highlighted the significant sex differences in the impact of diabetes on trochanteric BMD among patients with OPFs. The male diabetic patients had higher trochanteric BMD than their non-diabetic counterparts; however, this association was not evident in female patients. Further research is necessary to understand the underlying mechanisms that contribute to these sex-specific differences and to evaluate the clinical implications of managing fracture risk in diabetic patients.
骨质疏松性骨折（OPF）患者中糖尿病（DM）与骨密度（BMD）之间的关系仍然复杂且具有异质性，尤其是在性别之间。本研究旨在探讨OPF患者队列中糖尿病状态与转子骨密度之间的关联，并阐明男性和女性患者之间的差异。
对710名年龄在50岁及以上的OPF住院患者进行了这项回顾性分析。在本研究中，暴露变量为糖尿病状态。转子骨密度为因变量。在控制协变量影响的同时，应用广义估计方程（GEE）来检验OPF患者中糖尿病状态与转子骨密度之间的独立联系。此外，还进行了亚组分析以验证结果的稳定性。
通过完全调整模型确定，糖尿病患者的糖尿病状态与转子骨密度之间存在显著正相关（β = 0.017，95% CI 0.001至0.033，P = 0.035）。此外，按性别分析显示，男性患者的糖尿病状态与转子骨密度之间存在显著正相关（β = 0.040，95% CI 0.006至0.075，P = 0.022），而女性患者中未观察到显著相关性（β = 0.010，95% CI -0.008至0.028，P = 0.256）。
本研究强调了糖尿病对OPF患者转子骨密度影响的显著性别差异。男性糖尿病患者的转子骨密度高于非糖尿病患者；然而，这种关联在女性患者中并不明显。有必要进一步研究以了解导致这些性别特异性差异的潜在机制，并评估管理糖尿病患者骨折风险的临床意义。
