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5. The association of type 2 diabetes‐related characteristics with fracture risk at different sites.

Author

van Hulten, Veerle, Souverein, Patrick C., Starup‐Linde, Jakob, Viggers, Rikke, Klungel, Olaf H., Vestergaard, Peter, Brouwers, Martijn C. J. G., van den Bergh, Joop P., and Driessen, Johanna H. M.

Subjects
TYPE 2 diabetes, GLYCEMIC control, HUMERAL fractures, SKULL fractures, HIP fractures, ANKLE
Abstract

Aim: To determine the association of diabetes‐related characteristics with fractures at different sites in individuals with type 2 diabetes (T2D). Materials and Methods: We conducted a cohort study using the Clinical Practice Research Datalink (CPRD) GOLD. Patients aged over 30 years with T2D were identified within the CPRD. Patients were followed from the start of diabetes treatment until the end of data collection, death, or the occurrence of a fracture. Cox proportional hazards models were used to estimate the hazard ratios for the association of the individual characteristics (diabetes duration, glycated haemoglobin [HbA1c] level, and microvascular complications) with fracture risk, adjusted for demographics, comorbidities and comedication. Results: A diabetes duration of >10 years was associated with an increased risk of any fracture and major osteoporotic fractures (MOFs), while a diabetes duration of >8 years was associated with an increased hip fracture risk, compared to a duration <2 years. An HbA1c level <6% was associated with an increased fracture risk compared to HbA1c values of 6% to <7%. The presence of one or two microvascular complications was associated with an increased risk of any fracture and MOFs and the presence of two microvascular complications was associated with an increased hip fracture risk, compared to no microvascular complications. Conclusion: In conclusion, our study shows that a diabetes duration of 10 years or more, strict glycaemic control resulting in HbA1c levels below 6%, and/or the presence of at least one microvascular complication increased the risk of any fracture, hip fractures, MOFs, and humerus fractures, but not ankle, scapula or skull fractures. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Bone and Diabetes

Author

Starup-Linde, Jakob, Gregersen, Søren, Lenzi, Andrea, Series Editor, Jannini, Emmanuele A., Series Editor, Bonora, Enzo, editor, and DeFronzo, Ralph A., editor

Published
2020
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10. Bone and Diabetes

Author

Starup-Linde, Jakob, Gregersen, Søren, Lenzi, Andrea, Series Editor, Jannini, Emmanuele A., Series Editor, Bonora, Enzo, editor, and DeFronzo, Ralph A., editor

Published
2018
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15. The associations of sodium‐glucose cotransporter‐2 inhibitors versus dipeptidyl peptidase‐4 inhibitors as add‐on to metformin with fracture risk in patients with type 2 diabetes mellitus

Author

van Hulten, Veerle, primary, Driessen, Johanna H. M., additional, Starup‐Linde, Jakob K., additional, Al‐Mashhadi, Zheer K., additional, Viggers, Rikke, additional, Klungel, Olaf H., additional, Souverein, Patrick C., additional, Vestergaard, Peter, additional, Stehouwer, Coen D. A., additional, and van den Bergh, Joop P., additional

Published
2023
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21. The associations of sodium-glucose cotransporter-2 inhibitors versus dipeptidyl peptidase-4 inhibitors as add-on to metformin with fracture risk in patients with type 2 diabetes mellitus

Author

van Hulten, Veerle, Driessen, Johanna H M, Starup-Linde, Jakob K, Al-Mashhadi, Zheer K, Viggers, Rikke, Klungel, Olaf H, Souverein, Patrick C, Vestergaard, Peter, Stehouwer, Coen D A, van den Bergh, Joop P, van Hulten, Veerle, Driessen, Johanna H M, Starup-Linde, Jakob K, Al-Mashhadi, Zheer K, Viggers, Rikke, Klungel, Olaf H, Souverein, Patrick C, Vestergaard, Peter, Stehouwer, Coen D A, and van den Bergh, Joop P

Abstract

AIM: To investigate whether sodium-glucose cotransporter-2 (SGLT2) inhibitor use as compared to dipeptidyl peptidase-4 (DPP-4) inhibitor use as add-on to metformin is associated with the risk of any fracture or major osteoporotic fractures (MOFs).METHODS: A cohort study using the Clinical Practice Research Datalink (CPRD) Aurum database was conducted. All patients aged 18 years and older with a first-ever prescription for a DPP-4 inhibitor or an SGLT2 inhibitor as add-on to metformin between January 1, 2013 and June 30, 2020 were selected. Patients starting with SGLT2 inhibitors were matched (up to 1:3) on propensity scores to patients starting with DPP-4 inhibitors. Propensity scores were calculated based on sex, age, body mass index, comorbidities, comedication and lifestyle factors. Cox proportional hazard models were used to estimate the risk of fracture with SGLT2 inhibitor use as compared to DPP-4 inhibitor use.RESULTS: A total of 13 807 SGLT2 inhibitor users (age 55.4 ± 10.6 years, 36.7% female) were included in this study, matched with 28 524 DPP-4 inhibitor users (age 55.4 ± 8.0 years, 36.4% female). The risk of any fracture with current SGLT2 inhibitor use was similar compared with current DPP-4 inhibitor use (adjusted hazard ratio [aHR] 1.09, 95% confidence interval [CI] 0.91-1.31), as was the risk of MOFs (aHR 0.89, 95% CI 0.64-1.22) and the risk of fractures at any of the individual MOF sites. Additionally, no association was found with duration of SGLT2 inhibitor use (longest duration >811 days) for any of the individual SGLT2 inhibitor agents, or after stratification by sex and age.CONCLUSION: Use of SGLT2 inhibitors was not associated with the risk of any fracture, MOFs or fracture at the individual MOF sites when compared to DPP-4 inhibitor use.

Published
2023

22. The associations of sodium-glucose cotransporter-2 inhibitors versus dipeptidyl peptidase-4 inhibitors as add-on to metformin with fracture risk in patients with type 2 diabetes mellitus

Author

Sub Gen. Pharmacoepi and Clinical Pharm, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, PECP - Centre for Pharmacoepidemiology, van Hulten, Veerle, Driessen, Johanna H M, Starup-Linde, Jakob K, Al-Mashhadi, Zheer K, Viggers, Rikke, Klungel, Olaf H, Souverein, Patrick C, Vestergaard, Peter, Stehouwer, Coen D A, van den Bergh, Joop P, Sub Gen. Pharmacoepi and Clinical Pharm, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, PECP - Centre for Pharmacoepidemiology, van Hulten, Veerle, Driessen, Johanna H M, Starup-Linde, Jakob K, Al-Mashhadi, Zheer K, Viggers, Rikke, Klungel, Olaf H, Souverein, Patrick C, Vestergaard, Peter, Stehouwer, Coen D A, and van den Bergh, Joop P

Published
2023

32. Diabetes and bone - from cell to human

Author

Vestergaard, Peter, Catalano, Antonino, and Starup-Linde, Jakob

Subjects
diabetes, alendronate, antidiabetics medication, fractures, bone
Published
2022

33. Editorial: Diabetes and bone - from cell to human

Author

Vestergaard, Peter, Catalano, Antonino, and Starup-Linde, Jakob

Subjects
Diabetes Mellitus/therapy, diabetes, Endocrinology, Diabetes and Metabolism, Diabetes Mellitus, Humans, alendronate, antidiabetics medication, fractures, bone, Bone and Bones
Published
2022

41. Bone Density and Structure in Overweight Men With and Without Diabetes

Author

Starup-Linde, Jakob, primary, Ornstrup, Marie Juul, additional, Kjær, Thomas Nordstrøm, additional, Lykkeboe, Simon, additional, Handberg, Aase, additional, Gregersen, Søren, additional, Harsløf, Torben, additional, Pedersen, Steen Bønløkke, additional, Vestergaard, Peter, additional, and Langdahl, Bente Lomholt, additional

Published
2022
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