Abstract

Aims Previous evidence has demonstrated an increased fracture risk among the population with type 2 diabetes mellitus (T2DM). This study investigated the prevalence of bone fractures in elderly subjects (with and without type 2 diabetes) and identified any fracture risk factors, especially the risk factors for common known fractures in particular diabetic populations. Methods This cross-sectional study was conducted with community-dwelling people over 60 years old in nine communities from the city of Shenyang, which is the capital of Northeast China's Liaoning Province. A total of 3430 elderly adults (2201 females, mean ± standard deviation age 68.16 ± 6.1 years; 1229 males, 69.16 ± 6.7 years) were included. Our study measured the heel bone mineral density (BMD) and used the timed “up and go” (TUG) test and other indicators. In addition, we performed logistic regression analysis to explore the risk factors for fractures in the general population and the diabetic population and to analyze the differences. Results The results revealed that a total of 201 elderly persons (5.8%), with an average age of 70.05 ± 6.54 years, suffered from a history of fragility fractures, which affected more females (74.6%) than males (p = 0.001). The prevalence of fractures in the T2DM population was 7.3%, which was much higher than the 5.2% in non-T2DM population (p = 0.001). The prevalence of fractures in the T2DM population was 7.3%, which was much higher than the 5.2% in non-T2DM population (p = 0.001). The prevalence of fractures in the T2DM population was 7.3%, which was much higher than the 5.2% in non-T2DM population (p = 0.001). The prevalence of fractures in the T2DM population was 7.3%, which was much higher than the 5.2% in non-T2DM population (T‐score≤−2.5 (OR 1.750) were independent risk factors for fragility fractures in the non-T2DM population, but they were not risk factors in the T2DM population. Conclusions This study found that low BMD and slow TUG time were independent risk factors for fractures in non-T2DM patients, while no associations were found in the T2DM population. Patients with T2DM have a higher risk for fractures even when they have sufficient BMD and a short TUG time. TUG and BMD underestimated the risk for fractures in the T2DM population.

Highlights

  • The prevalence rate of type 2 diabetes mellitus (T2DM) has increased to 18% around the world in 2017 [1], and the prevalence of T2DM in China’s elderly population has increased along with the aging of the Chinese population and the rise in unhealthy lifestyle habits, and environmental pollution [2]

  • Age, uric acid (UA), bone mineral density (BMD), and timed “up and go” (TUG) time were different between the fracture group and the nonfracture group in the nondiabetic population

  • Our study found that the prevalence rate of fragility fractures in the diabetic population was 7.3%, which is much higher than the 5.2% in the non-T2DM population (p = 0:018, Table 1), and analyzed the association between fractures and diabetes, hypertension (HTN), glycosylated hemoglobin (HbA1c), blood lipids, Body mass index (BMI), level of serum 25 (OH)D3, insulin use, oral antidiabetic medication, creatinine clearance (Ccr), etc

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Summary

Introduction

The prevalence rate of type 2 diabetes mellitus (T2DM) has increased to 18% (aged 65-99) around the world in 2017 [1], and the prevalence of T2DM in China’s elderly population has increased along with the aging of the Chinese population and the rise in unhealthy lifestyle habits, and environmental pollution [2]. Most studies have revealed that bone mineral density (BMD) is not lower in patients with T2DM, and it is higher than that in non-T2DM persons [6,7,8], but the cause of this phenomenon is not yet clear. Some studies have shown that the TUG test is a sensitive and specific measure for community-dwelling adults in Journal of Diabetes Research predicting falls and an independent risk factor for fracture [10, 11], but the relationship between TUG and fracture risk in T2DM-specific populations is unclear. It is of great interest to us to evaluate whether the TUG results could predict fractures in diabetic populations. We performed a crosssectional study to investigate the prevalence of fractures in a population of 3430 elderly subjects (with and without type 2 diabetes) in order to identify fracture risk factors and, in particular, to assess the risk factors for common fractures in particular diabetic populations

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