Comparison of FRAX in postmenopausal Asian women with and without type 2 diabetes mellitus: a retrospective observational study

Wang, Chen; Liu, Jun; Xiao, Li; Liú, Dan; Yan, Wenjing; Hu, Ting; Li, Kunhong; Hua, Xiaociao; Zeng, Xianmin

doi:10.1177/0300060519879591

Cited by 6 publications

(6 citation statements)

References 42 publications

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“…As previously stated, the management of fracture risk in the T2DM population remains challenging since BMD tends to be relatively preserved or even higher than in healthy subjects [ 2 , 3 ]. We found out that FRAX-Port® constitutes an easy and effective alternative tool to predict fracture risk within this population and can guide the decision on performing bone densitometry and starting anti-osteoporotic therapy, which is consistent with previous studies [ 5 - 7 ].…”

Section: Discussionsupporting

confidence: 90%

Evaluation of Usage of a Fracture Risk Assessment by FRAX Tool in Adults With Type 2 Diabetes Mellitus

Monteiro¹,

Santos²,

Fonseca³

et al. 2023

Cureus

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Background: Fragility fractures are increasingly recognized as a complication of type 2 diabetes mellitus (T2DM). The FRAX-Port® is a calculation tool that assesses the 10-year risk of either major and hip fracture, integrating several clinical risk factors, including T2DM. We aimed to evaluate the fracture risk in adults with T2DM and determine the rate of patients at high risk for fracture under anti-osteoporotic therapy.Methods: We developed a cross-sectional study, including a convenience sample of adults with T2DM, followed in our tertiary center between 2019 and 2022. Fracture risk was evaluated according to FRAX-Port®.Results: One hundred adults were included, 54% male, with a mean age of 68.4±9.2 years. Respecting fracture risk factors, 17% had a previous fragility fracture, 12% had a history of hip fracture in their parents, 9% had active alcohol consumption, and 4% had active smoking. Additionally, 17% presented secondary osteoporosis, being the most frequent cause of systemic corticosteroid exposure (10%). Regarding diabetesspecific risk factors, 94% had a diabetes duration longer than five years; HbA1c greater than 7% in 70%; 42% had diabetic retinopathy, 33% had diabetic chronic kidney disease, 18% had peripheral neuropathy, and 7% had autonomic neuropathy; 83% were on insulin, 2% on canagliflozin and 1% on pioglitazone. According to the FRAX-Port®, the median probability of major fracture was 6.8% (IQR 6.9), and hip fracture was 2.4% (IQR 3.9). Fracture risk was high, intermediate, and low at 41%, 15%, and 44%, respectively. Lastly, 56% of participants should undergo bone densitometry and 45% had a formal recommendation to begin an antiosteoporotic treatment. However, only 6% were under anti-osteoporotic therapy: bisphosphonates (5%) and denosumab (1%).Conclusions: More than a third of T2DM patients evaluated had a high fracture risk. We found that FRAX-Port® is an easy-to-apply tool, which helps in the decision to perform densitometry or to institute antiosteoporotic therapy. Given the increasing prevalence of T2DM and the associated risk of falls, this study highlights the need to recognize the fracture risk in these patients, usually a forgotten complication during the screening of risk factors for adverse events in adults with T2DM.

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Section: Discussionsupporting

confidence: 90%

Evaluation of Usage of a Fracture Risk Assessment by FRAX Tool in Adults With Type 2 Diabetes Mellitus

Monteiro¹,

Santos²,

Fonseca³

et al. 2023

Cureus

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“…Nevertheless, compared with these patients without DM, a given T-score or FRAX score was associated with higher fracture risk in older adults with DM (47). This finding has confirmed the useful of BMD T-score and FRAX score for clinical evaluation of fracture risk, and prompted a series of subsequent studies (52,53).…”

Section: Authorsmentioning

confidence: 66%

Mapping Knowledge Landscapes and Emerging Trends of the Links Between Bone Metabolism and Diabetes Mellitus: A Bibliometric Analysis From 2000 to 2021

Cheng

Guo

Yang

et al. 2022

Front. Public Health

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BackgroundDiabetes mellitus (DM) have become seriously threatens to human health and life quality worldwide. As a systemic metabolic disease, multiple studies have revealed that DM is related to metabolic bone diseases and always induces higher risk of fracture. In view of this, the links between bone metabolism (BM) and DM (BMDM) have gained much attention and numerous related papers have been published. Nevertheless, no prior studies have yet been performed to analyze the field of BMDM research through bibliometric approach. To fill this knowledge gap, we performed a comprehensive bibliometric analysis of the global scientific publications in this field.MethodsArticles and reviews regarding BMDM published between 2000 and 2021 were obtained from the Web of Science after manually screening. VOSviewer 1.6.16, CiteSpace V 5.8.R3, Bibliometrix, and two online analysis platforms were used to conduct the bibliometric and visualization analyses.ResultsA total of 2,525 documents including 2,255 articles and 270 reviews were retrieved. Our analysis demonstrated a steady increasing trend in the number of publications over the past 22 years (R2 = 0.989). The United States has occupied the leading position with the largest outputs and highest H-index. University of California San Francisco contributed the most publications, and Schwartz AV was the most influential author. Collaboration among institutions from different countries was relatively few. The journals that published the most BMDM-related papers were Bone and Osteoporosis International. Osteoporosis and related fractures are the main bone metabolic diseases of greatest concern in this field. According to co-cited references result, “high glucose environment,” “glycation end-product” and “sodium-glucose co-transporter” have been recognized as the current research focus in this domain. The keywords co-occurrence analysis indicated that “diabetic osteoporosis,” “osteoarthritis,” “fracture risk,” “meta-analysis,” “osteogenic differentiation,” “bone regeneration,” “osteogenesis,” and “trabecular bone score” might remain the research hotspots and frontiers in the near future.ConclusionAs a cross-discipline research field, the links between bone metabolism and diabetes mellitus are attracting increased attention. Osteoporosis and related fractures are the main bone metabolic diseases of greatest concern in this field. These insights may be helpful for clinicians to recognize diabetic osteopenia and provide more attention and support to such patients.

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“… 22 Similarly, a study in postmenopausal Asian women found that the non-diabetic group had a lower BMD than the T2DM group. 23 Likewise, in another retrospective clinical study from Rome, T2DM patients were found to have significantly higher mean femoral neck BMD and T-score values than non-diabetic. 24 The reason for the incongruity in the BMD results for T2DM versus non-diabetic subjects in various studies is not clear; however, differences in the age, BMI, menopausal status, and other baseline characteristics between T2DM subjects and the non-diabetics in some studies may partly clarify this inconsistency.…”

Section: Discussionmentioning

confidence: 91%

“…A study carried out by Ohira et al 25 included that 47,389 Japanese women showed FRAX for major osteoporotic fracture risk was not significantly different between individuals with T2DM and non-diabetics, despite the fracture rate in the past 5 years being significantly higher in the diabetic group. In contrast, a study carried out by Wang et al 23 that included 1014 individuals )500 T2DM( found that T2DM had a higher FRAX compared with the non-diabetics group, even after controlling age, gender, BMI, smoking condition, alcohol intake, and low-density lipoprotein levels. Conversely, in another study, the FRAX of both MOF and HF was considerably lower in the entire sample and in males with diabetes than in control subjects, but no significant differences were seen between women with diabetes and control subjects.…”

mentioning

confidence: 83%

“…In contrast to our results, other literature found that patients with T2DM have greater BMD values than non-diabetic patients. 16,[20][21][22][23][24] A study carried out by Bayani et al 16 demonstrated that BMD of the lumbar spine was significantly greater in older women with diabetes than non-diabetes, however, no difference was observed for femoral neck BMD between the 2 groups. In the latter study, patients with diabetes had a lower prevalence of osteoporosis and osteopenia than non-diabetics.…”

mentioning

confidence: 99%

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Comparison of bone mineral density and Fracture Risk Assessment Tool in Saudi women with and without type 2 diabetes mellitus

Alfadhli

Alsharif

Alharbi

et al. 2022

SMJ

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Objectives: To compare the bone mineral density and the fracture risks in Saudi women with and without type 2 diabetes mellitus )T2DM(. Methods:This cross-sectional study was carried out at Taibah Early Diagnostic Center, Al Madinah Al Munawarah, Saudi Arabia. A total of 465 women with and without T2DM aged ≥40 years who visited the center for a dual-energy X-ray absorptiometry scan between December 2020 and July 2021 were randomly selected. The 10-year probabilities of major osteoporotic fracture )MOF( and hip fracture )HF( were calculated using the Original ArticleAbu Dhabi Fracture Risk Assessment Tool )FRAX( with and without adjustment for T2DM. The adjustment was made by setting rheumatoid arthritis as the equivalent risk for T2DM in the FRAX. Bone mineral density values and the FRAX scores were compared between women with T2DM and non-diabetes.Results: Of 465 women, 214 had T2DM, and 251 were non-diabetics. The mean age of women was 59.42±7.9 years. There were no significant differences in mean age, menopausal status, height, weight, and body mass index between T2DM and non-diabetic women. Bone mineral density values and the unadjusted FRAX scores were comparable between the 2 groups. However, after adjusting FRAX for T2DM, the FRAX for MOF and HF became significantly higher in T2DM women )p=0.000 and p=0.004(. Conclusion:In Saudi women with T2DM, unadjusted FRAX underestimated the risk of MOF and HF. Type 2 diabetes mellitus should be included as one of the clinical risk factors for fracture in future versions of the FRAX score.

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Comparison of FRAX in postmenopausal Asian women with and without type 2 diabetes mellitus: a retrospective observational study

Cited by 6 publications

References 42 publications

Evaluation of Usage of a Fracture Risk Assessment by FRAX Tool in Adults With Type 2 Diabetes Mellitus

Evaluation of Usage of a Fracture Risk Assessment by FRAX Tool in Adults With Type 2 Diabetes Mellitus

Mapping Knowledge Landscapes and Emerging Trends of the Links Between Bone Metabolism and Diabetes Mellitus: A Bibliometric Analysis From 2000 to 2021

Comparison of bone mineral density and Fracture Risk Assessment Tool in Saudi women with and without type 2 diabetes mellitus

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