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Original Article
Fracture Incidence and Risk of Osteoporosis in Female Type 2 Diabetic Patients in Korea
Jong Kwan Jung, Hyo Jeong Kim, Hong Kyu Lee, Sang Soo Kim, Chan Soo Shin, Jin Taek Kim
Diabetes Metab J. 2012;36(2):144-150.   Published online April 17, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.2.144
  • 4,481 View
  • 40 Download
  • 15 Crossref
AbstractAbstract PDFPubReader   
Background

There are no published data regarding fracture risk in type 2 diabetic patients in Korea. In this study, we compared the fracture incidence and risk of osteoporosis of type 2 diabetic female patients with those in a non-diabetic hypertensive cohort.

Methods

The incidence of fracture in a type 2 diabetic cohort was compared with that in a non-diabetic hypertensive cohort over the course of 7 years. Female type 2 diabetic and non-diabetic hypertensive patients who visited Eulji General Hospital outpatient clinic from January 2004 to April 2004 were assigned to the diabetic cohort and the non-diabetic hypertensive cohort, respectively. Surveys on fracture event, use of anti-osteoporosis medications, and bone mineral density were performed.

Results

The number of fractures was 88 in the female diabetic cohort (n=1,268, 60.6±11.5 years) and 57 in the female non-diabetic hypertensive cohort (n=1,014, 61.4±11.7 years). The RR in the diabetic cohort was 1.38 (P=0.064; 95% confidence interval [CI], 0.98 to 1.94) when adjusted for age. Diabetic patients with microvascular complications (61.0%) showed a higher RR of 1.81 (P=0.014; 95% CI, 1.13 to 2.92) compared with those without these complications. The prevalence of osteoporosis was comparable between the groups, while use of anti-osteoporosis medication was more common in the diabetic cohort (12.8%) than in the hypertensive cohort (4.5%) (P<0.001).

Conclusion

In our study, a higher fracture risk was observed in female type 2 diabetics with microvascular complications. Special concern for this risk group is warranted.

Citations

Citations to this article as recorded by  
  • Research Progress on How to Prevent Osteoporosis in Diabetic Patients
    婷玉 牛
    Advances in Clinical Medicine.2022; 12(02): 1178.     CrossRef
  • Differences in the roles of types 1 and 2 diabetes in the susceptibility to the risk of fracture: a systematic review and meta-analysis
    Jiaqing Dou, Jing Wang, Qiu Zhang
    Diabetology & Metabolic Syndrome.2021;[Epub]     CrossRef
  • The risk of hip and non-vertebral fractures in type 1 and type 2 diabetes: A systematic review and meta-analysis update
    Tatiane Vilaca, Marian Schini, Susan Harnan, Anthea Sutton, Edith Poku, Isabel E. Allen, Steven R. Cummings, Richard Eastell
    Bone.2020; 137: 115457.     CrossRef
  • Diabetes mellitus and risk of low-energy fracture: a meta-analysis
    Jing Bai, Qian Gao, Chen Wang, Jia Dai
    Aging Clinical and Experimental Research.2020; 32(11): 2173.     CrossRef
  • Diabetes mellitus and the risk of fractures at specific sites: a meta-analysis
    Hao Wang, Ying Ba, Qian Xing, Jian-Ling Du
    BMJ Open.2019; 9(1): e024067.     CrossRef
  • The use of metformin, insulin, sulphonylureas, and thiazolidinediones and the risk of fracture: Systematic review and meta‐analysis of observational studies
    Khemayanto Hidayat, Xuan Du, Meng‐Jiao Wu, Bi‐Min Shi
    Obesity Reviews.2019; 20(10): 1494.     CrossRef
  • Bei Diabetikern an eine Osteoporose denken!
    Stephan Scharla
    MMW - Fortschritte der Medizin.2018; 160(21-22): 65.     CrossRef
  • Type 2 diabetes and risk of low-energy fractures in postmenopausal women: meta-analysis of observational studies
    Joanna Dytfeld, Michał Michalak
    Aging Clinical and Experimental Research.2017; 29(2): 301.     CrossRef
  • Risk of low-energy fracture in type 2 diabetes patients: a meta-analysis of observational studies
    P. Jia, L. Bao, H. Chen, J. Yuan, W. Liu, F. Feng, J. Li, H. Tang
    Osteoporosis International.2017; 28(11): 3113.     CrossRef
  • Comorbidity and its relationship with health service use and cost in community-living older adults with diabetes: A population-based study in Ontario, Canada
    Kathryn Fisher, Lauren Griffith, Andrea Gruneir, Dilzayn Panjwani, Sima Gandhi, Li (Lisa) Sheng, Amiram Gafni, Patterson Chris, Maureen Markle-Reid, Jenny Ploeg
    Diabetes Research and Clinical Practice.2016; 122: 113.     CrossRef
  • Type 2 diabetes mellitus and bone fragility: Special focus on bone imaging
    Yong Jun Choi, Yoon-Sok Chung
    Osteoporosis and Sarcopenia.2016; 2(1): 20.     CrossRef
  • Epidemiology of fractures in type 2 diabetes
    Ann V. Schwartz
    Bone.2016; 82: 2.     CrossRef
  • Efficacy and Safety of Weekly Alendronate Plus Vitamin D35600 IU versus Weekly Alendronate Alone in Korean Osteoporotic Women: 16-Week Randomized Trial
    Kwang Joon Kim, Yong-Ki Min, Jung-Min Koh, Yoon-Sok Chung, Kyoung Min Kim, Dong-Won Byun, In Joo Kim, Mikyung Kim, Sung-Soo Kim, Kyung Wan Min, Ki Ok Han, Hyoung Moo Park, Chan Soo Shin, Sung Hee Choi, Jong Suk Park, Dong Jin Chung, Ji Oh Mok, Hong Sun Ba
    Yonsei Medical Journal.2014; 55(3): 715.     CrossRef
  • Increased Risk of Fracture and Postfracture Adverse Events in Patients With Diabetes: Two Nationwide Population-Based Retrospective Cohort Studies
    Chien-Chang Liao, Chao-Shun Lin, Chun-Chuan Shih, Chun-Chieh Yeh, Yi-Cheng Chang, Yuan-Wen Lee, Ta-Liang Chen
    Diabetes Care.2014; 37(8): 2246.     CrossRef
  • Aortic Calcification and Bone Metabolism: The Relationship between Aortic Calcification, BMD, Vertebral Fracture, 25-Hydroxyvitamin D, and Osteocalcin
    Kwang Joon Kim, Kyoung Min Kim, Kyeong Hye Park, Han Seok Choi, Yumie Rhee, Yong Ho Lee, Bong Soo Cha, Myong Jin Kim, Sun Min Oh, J. Keenan Brown, Sung Kil Lim
    Calcified Tissue International.2012; 91(6): 370.     CrossRef
Review
Diabetes and Osteoporosis.
Ki Won Oh
Korean Diabetes J. 2009;33(3):169-177.   Published online June 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.3.169
  • 1,990 View
  • 23 Download
  • 7 Crossref
AbstractAbstract PDF
Increased life expectancy and increased obesity have contributed to an increasing incidence of osteoporosis and diabetes mellitus. Recent meta-analyses and cohort studies confirm that diabetes is associated with a higher risk of fracture. Patients with type 2 diabetes exhibit increased fracture risks despite a higher bone mass, which are mainly attributable to non-skeletal risk factors. Patients with type 1 diabetes may have impaired bone formation because of absence of the anabolic effects of insulin and insulin-like growth factor I (IGF-I) system. Several clinical studies have reported adverse skeletal actions of peroxisome proliferator-activated receptor gamma (PPARgamma) agonist in humans. Obesity regulates bone metabolism not only by increasing weight loading but also by modulating adipokines that are known to affect bone remodeling.

Citations

Citations to this article as recorded by  
  • Relationship between hs-CRP and HbA1c in Diabetes Mellitus Patients: 2015–2017 Korean National Health and Nutrition Examination Survey
    Yo-Han Seo, Hee-Young Shin
    Chonnam Medical Journal.2021; 57(1): 62.     CrossRef
  • Correlation between Serum Osteocalcin and Hemoglobin A1c in Gwangju General Hospital Patients
    Yo-Han Seo, Hee-Young Shin
    The Korean Journal of Clinical Laboratory Science.2018; 50(3): 313.     CrossRef
  • Bergapten exerts inhibitory effects on diabetes-related osteoporosis via the regulation of the PI3K/AKT, JNK/MAPK and NF-κB signaling pathways in osteoprotegerin knockout mice
    Xue-Ju Li, Zhe Zhu, Si-Lin Han, Zi-Long Zhang
    International Journal of Molecular Medicine.2016; 38(6): 1661.     CrossRef
  • The association of Osteoporosis and Thyroid Hormone in euthyroid adults
    Hyun Yoon, Eun-Jin Ryu
    Journal of the Korea Academia-Industrial cooperation Society.2015; 16(2): 1137.     CrossRef
  • A Study on the Correlation between Menopausal Rating Scale and Bone Mineral Density for Menopausal Osteoporosis Patients
    Kyu In Kwak, Jae Hui Kang, Yun Joo Kim, Hyun Lee
    The Acupuncture.2014; 31(3): 25.     CrossRef
  • Factors Associated with Bone Mineral Density in Korean Postmenopausal Women Aged 50 Years and Above: Using 2008-2010 Korean National Health and Nutrition Examination Survey
    Son-Ok Mun, Jihye Kim, Yoon Jung Yang
    Korean Journal of Community Nutrition.2013; 18(2): 177.     CrossRef
  • Influencing Factors of Bone Mineral Density in Men
    Dong-Ha Lee, Eun-Nam Lee
    Journal of muscle and joint health.2011; 18(1): 5.     CrossRef

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