Clinical risk factors for fracture risk prediction in patients with type 2 diabetes using adjusted FRAX / 中华内分泌外科杂志

ABSTRACT

Objective:To study the clinical risk factors for osteoporotic fracture (OF) risk prediction in patients with type 2 diabetes mellitus (T2DM) using adjusted fracture risk assessment tool (FRAX) .Methods:A cross-sectional study of 429 patients with T2DM who were hospitalized in the Department of Endocrinology and Geriatrics of the Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical University from Sep. 2019 to Sep. 2020 was conducted. Participants were divided into OF low-risk group and OF high-risk group. Participant characteristics (age, gender, height, weight, waist, blood pressure, history of drug treatment, serum glucose, glycosylated hemoglobin, total cholesterol, low-density lipoprotein cholesterol (LDL-C) , high-density lipoprotein cholesterol (HDL-C) , triglyceride, serum uric acid, alkaline phosphatase, and thyroid stimulating hormone levels, urine protein/creatinine ratio, urea, creatinine and TPOAB) and dual energy x-ray absorptiometry results were obtained and analyzed. Logistic regression model was used to investigate the relationship between the OF risk of T2DM assessed by adjusted FRAX and clinical risk factors.Results:Patients in the OF high-risk group accounted for 9.09% of the subjects. After adjustment for other variables, the duration of diabetes was still positively associated with significantly elevated risk of OF assessed by adjusted FRAX ( OR 7.660, 95% CI 1.661-35.334, P=0.009) , whereas the blood uric acid was negatively associated with significantly elevated risk of OF assessed by adjusted FRAX ( OR 0.345, 95 % CI 0.128-0.928, P=0.035) .Likewise, LDL-C levels decreased the odds of the risk of OF assessed by adjusted FRAX ( OR 0.316, 95 % CI 0.114-0.881, P=0.028) . There was no significant relationship between alkaline phosphatase ( OR 1.902, 95 % CI 0.904-4.004, P=0.090) as well as total cholesterol ( OR 0.297, 95% CI 0.056~1.560, P=0.151) levels and the elevated risk of OF assessed by adjusted FRAX. Conclusion:Diabetes duration could be a risk factor for OF risk prediction in patients with T2DM using adjusted FRAX, and serum uric acid and LDL-C could be protective factors for OF risk prediction in patients with T2DM using adjusted FRAX.