Self-reported low-energy fractures and associated risk factors in people with diabetes: A national population-based study

Furtado, Sofia; Rodrigues, Ana Maria; Dias, Sara Simões; Branco, Jaime; Canhão, Helena

doi:10.1016/j.diabres.2018.11.015

Cited by 6 publications

(4 citation statements)

References 31 publications

(43 reference statements)

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“…Duration of symptoms was further categorised as no symptoms, symptoms ≤5 years and symptoms >5 years. Low‐energy fracture was defined as a fracture resulting from trauma that would not normally result in fracture in a healthy individual 15 …”

Section: Methodsmentioning

confidence: 99%

Coeliac disease re‐screening among once seronegative at‐risk relatives: A long‐term follow‐up study

et al. 2022

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Background: Serological screening of the relatives of coeliac disease patients is widely endorsed. However, the need for and the optimal timing of possible retesting of once seronegative at-risk individuals for coeliac disease remain unclear.Objective: We investigated this issue by inviting a large cohort of previously screening-negative relatives of patients with coeliac disease to participate in a follow-up study. Methods: Altogether 599 relatives of coeliac disease index patients not diagnosed with coeliac disease in a screening study carried out in 2006-2010 were asked about possible later diagnosis or re-tested with coeliac disease autoantibodies in 2017-2021. Besides incidence, the possible impact of various patient-related clinical factors and HLA haplotype on the later diagnosis or screening positivity was examined.Results: Fifteen (2.5%) relatives were either diagnosed with a coeliac disease (n = 8) during the follow-up period or were found to be screening-positive in the re-testing (n = 7), giving a combined annual incidence of 221/100,000 person-years in all relatives and 336/100,000 among those carrying coeliac disease-associated HLA DQ2/DQ8. The new cases more often carried the high-risk (DQ2.5/2.5 or DQ2.5/ 2.2; 35.7% vs. 7.4%, respectively, p < 0.001) HLA and were younger at initial screening (23.3 vs. 40.5 years, p = 0.028) and -in spite of a negative screening outcome -had higher median transglutaminase antibody level in the first study than those not affected. There were no significant differences between the affected and non-affected relatives in other demographic data, degree of kinship with the index, current symptoms or frequency of chronic co-morbidities. Conclusion:The incidence rate for later coeliac disease diagnosis or new seropositivity in relatives who had been tested once was 221/100,000 person-years in all and 336/100,000 among those carrying at-risk HLA genetics after ∼10 years of follow-up. HLA-typing could help to target a subgroup of relatives who would benefit most from re-testing.

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Section: Methodsmentioning

confidence: 99%

Coeliac disease re‐screening among once seronegative at‐risk relatives: A long‐term follow‐up study

et al. 2022

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“…In a study by Li et al., patients with T2D were more prone to frailty than population controls, and higher frailty increased the risk of fragility fracture but not spine or hip fracture in T2D [32]. Frailty may potentially lead to falls, and a study showed that patients with diabetes reported more falls which was associated with low energy fractures [33]. In addition, sarcopenia, the presence of low muscle mass and low muscle function [34] has been positively associated with osteoporosis, fracture risk, and fall risk in postmenopausal women without diabetes [35].…”

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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“…In clinical practice, BMD levels below the osteoporotic threshold and fragile fracture risk assessment tools, such as the World Health Organization fracture risk assessment tool (FRAX), are used to determine when to initiate fracture prevention treatment 7 . However, some studies have reported that these tools underestimate the risk of fracture in patients with diabetes 8 .…”

Section: Introductionmentioning

confidence: 99%

Correlation between bone mineral density and type 2 diabetes mellitus in elderly men and postmenopausal women

Luo,

Li,

Zhou

et al. 2024

Sci Rep

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The relationship between bone mineral density and type 2 diabetes is still controversial. The aim of this study is to investigate the relationship between type 2 diabetes mellitus (T2DM) and bone mineral density (BMD) in elderly men and postmenopausal women. The participants in this study included 692 postmenopausal women and older men aged ≥ 50 years, who were divided into the T2DM group and non-T2DM control group according to whether or not they had T2DM. The data of participants in the two groups were collected from the inpatient medical record system and physical examination center systems, respectively, of the Tertiary Class A Hospital. All data analysis is performed in SPSS Software. Compared with all T2DM group, the BMD and T scores of lumbar spines 1–4 (L1–L4), left femoral neck (LFN) and all left hip joints (LHJ) in the non-T2DM group were significantly lower than those in the T2DM group (P < 0.05), and the probability of major osteoporotic fracture in the next 10 years (PMOF) was significantly higher than that in T2DM group (P < 0.001). However, with the prolongation of the course of T2DM, the BMD significantly decreased, while fracture risk and the prevalence of osteoporosis significantly increased (P < 0.05). We also found that the BMD of L1-4, LFN and LHJ were negatively correlated with homeostatic model assessment-insulin resistance (HOMA-IR) (P = 0.028, P = 0.01 and P = 0.047, respectively). The results also showed that the BMD of LHJ was positively correlated with indirect bilirubin (IBIL) (P = 0.018). Although the BMD was lower in the non-T2DM group than in the T2DM group, the prolongation of the course of T2DM associated with the lower BMD. And the higher prevalence of osteoporosis and fracture risk significantly associated with the prolongation of the course of T2DM. In addition, BMD was significantly associated with insulin resistance (IR) and bilirubin levels in T2DM patients.Registration number: China Clinical Trials Registry: MR-51-23-051741; https://www.medicalresearch.org.cn/search/research/researchView?id=c0e5f868-eca9-4c68-af58-d73460c34028.

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Self-reported low-energy fractures and associated risk factors in people with diabetes: A national population-based study

Cited by 6 publications

References 31 publications

Coeliac disease re‐screening among once seronegative at‐risk relatives: A long‐term follow‐up study

Coeliac disease re‐screening among once seronegative at‐risk relatives: A long‐term follow‐up study

Diabetes and bone

Correlation between bone mineral density and type 2 diabetes mellitus in elderly men and postmenopausal women

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