Associations of body mass index and diabetes with hip fracture risk: a nationwide cohort study

Huang, Hsiu-Ling; Pan, Cheng-Chin; Hsiao, Yu-Fen; Chen, Mingchih; Kung, Chuan-Yu; Kung, Pei‐Tseng; Tsai, Wen‐Chen

doi:10.1186/s12889-018-6230-y

Cited by 27 publications

(22 citation statements)

References 23 publications

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“…Huang et al. [ 24 ] demonstrated that low weight patients (BMI < 18 kg/m 2 ) had a higher risk of sustaining fragility hip fractures. The present study demonstrated that patients who had BMI less than 21 kg/m 2 were more likely to die than those with BMI higher than 21 kg/m 2 .…”

Section: Discussionmentioning

confidence: 99%

One-year mortality rate after fragility hip fractures and associated risk in Nan, Thailand

Daraphongsataporn¹,

Saloa²,

Sriruanthong³

et al. 2020

Osteoporosis and Sarcopenia

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Objectives Fragility hip fracture is a common secondary complication of osteoporosis, which leads to significant morbidity and mortality. The incidence and prevalence of hip fractures have increased over recent decades. This study established an objective to determine the mortality rate and potential risk factors in fragility hip fracture patients. Methods Electronic medical records were retrospectively reviewed. A total of 1412 patients, aged 50 years and over, who sustained and received treatment for hip fractures between 2014 and 2018 were subsequently identified. Mortality rate data were retrieved from the official statistics registry for the provincial population. The mortality rates and potential risk factors for mortality were examined using Kaplan-Meier estimates and multivariate Cox proportional hazard models. Results The overall 1-year mortality rate of fragility hip fracture patients was 19%. Compared with the age-matched population in Nan province, hip fractures increased the mortality rate by 6.21 times. Additionally, the mortality of hip fracture patients was significantly higher among those with age above 80 years, nonambulatory status before fracture and upon hospital discharge, end-stage renal disease, delirium, and pneumonia. Conclusions Patients who sustained hip fractures had approximately 6 times higher mortality. Effective strategies for hip fracture prevention as well as improvement in the standard of care are crucial steps towards reducing mortality in patients with hip fracture.

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Section: Discussionmentioning

confidence: 99%

One-year mortality rate after fragility hip fractures and associated risk in Nan, Thailand

Daraphongsataporn¹,

Saloa²,

Sriruanthong³

et al. 2020

Osteoporosis and Sarcopenia

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“…In a study on obese patients, more than 50% of subjects, with at least one vertebral fracture, exhibited a normal or only slightly reduced BMD, but not osteoporosis, and vertebral fractures occurred 4.4-fold more frequently in patients than controls, thus suggesting that in obese population DXA may not represent an accurate instrument to adequately estimate the fracture risk (10). Data on the risk of hip fractures in obese patients are not conclusive even for the influence of diabetes (11). In fact, since obesity and excess fat mass, especially VAT, are increasing risk factors for low BMD and fragility fractures (3), in obese or overweight subjects the BMD measured by DXA may not be a reliable method of assessing fracture risk.…”

Section: Obesitymentioning

confidence: 97%

DIAGNOSIS OF ENDOCRINE DISEASE: Evaluation of bone fragility in endocrine disorders

Eller-Vainicher

Falchetti

Gennari

et al. 2019

European Journal of Endocrinology

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An underlying disease affecting bone health is present in up to 40 and 60% of osteoporotic postmenopausal women and men respectively. Among the disorders leading to a secondary form of osteoporosis, the endocrine diseases are highly represented. A frequent finding in patients affected with an endocrine-related forms of bone disease is that the skeletal fragility is partially independent of the bone density, since the fracture risk in these patients is related more to a reduction of bone quality than to a decrease of bone mass. As a consequence, bone mineral density evaluation by dual-X-ray absorptiometry may be inadequate for establishing the risk of fracture in the setting of the endocrine-related forms of osteoporosis. In the recent years, several attempts to non-invasively estimating bone quality have been done. Nowadays, some new tools are available in the clinical practice for optimising the fracture risk estimation in patients with endocrine disorders. The aim of this review is to summarise the evidence regarding the role of the different imaging tools for evaluating bone density and bone quality in the most frequent forms of endocrine-related osteoporosis, such as obesity, diabetes, acromegaly, thyrotoxicosis, primary hyperparathyroidism, hypercortisolism and hypogonadism. For each of these disorders, data regarding both the current available tools and the future possible new techniques for assessing bone fragility in patients with endocrine diseases are reported.

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“…For weight, Huang et al. [28] have previously presented the complex relationship between obesity and fracture risk. The authors showed in a large retrospective study, that obesity was positively associated with T2D.…”

Section: Fracture Riskmentioning

confidence: 99%

“…The authors showed in a large retrospective study, that obesity was positively associated with T2D. Interestingly, the study also showed that for patients with T2D, high BMI was associated with a lower risk of hip fracture compared with normal BMI [28]. However, when comparing different BMI-subgroups, the RR of hip fracture was only significantly increased for the T2D patients with a normal BMI compared with controls with similar BMI [28].…”

Section: Fracture Riskmentioning

confidence: 99%

Diabetes and bone

Hygum

Starup-Linde

Langdahl

2019

Osteoporosis and Sarcopenia

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Bone disease is a serious complication to diabetes. Patients with type 1 diabetes (T1D) and type 2 diabetes (T2D) suffer from an increased risk of fracture, most notably at the hip, compared with patients without diabetes. Confounders such as patient sex, age, body mass index, blood glucose status, fall risk, and diabetes medications may influence the fracture risk. Different underlying mechanisms contribute to bone disease in patients with diabetes. Bone quality is affected by low bone turnover in T1D and T2D, and furthermore, incorporation of advanced glycation end-products, changes in the incretin hormone response, and microvascular complications contribute to impaired bone quality and increased fracture risk. Diagnosis of bone disease in patients with diabetes is a challenge as current methods for fracture prediction such as bone mineral density T-score and fracture risk assessment tools underestimate fracture risk for patients with T1D and T2D. This review focuses on bone disease and fracture risk in patients with diabetes regarding epidemiology, underlying disease mechanisms, and diagnostic methods, and we also provide considerations regarding the management of diabetes patients with bone disease in terms of an intervention threshold and different treatments.

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Associations of body mass index and diabetes with hip fracture risk: a nationwide cohort study

Cited by 27 publications

References 23 publications

One-year mortality rate after fragility hip fractures and associated risk in Nan, Thailand

One-year mortality rate after fragility hip fractures and associated risk in Nan, Thailand

DIAGNOSIS OF ENDOCRINE DISEASE: Evaluation of bone fragility in endocrine disorders

Diabetes and bone

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