Lifestyle-Related Metabolic Disorders, Osteoporosis, and Fracture Risk in Asia: A Systematic Review

Sugimoto, Toshitsugu; Sato, Masayo; Dehle, Francis C.; Brnabic, Alan; Weston, Adèle R.; Burge, Russel

doi:10.1016/j.vhri.2015.09.005

Cited by 54 publications

(36 citation statements)

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“…Although a proportion of patients in both the T2DM and non-DM groups developed clinical fractures during the follow-up period, the proportion in the T2DM group was significantly larger than in the non-DM group (12.7% vs 9.9%; P < 0.001; Table 2). This difference reflects the additional fracture risk posed by T2DM (independent of osteoporosis), as has been observed in previous studies [4, 5, 8]. These findings suggest that both physicians and patients need to carefully consider the potential impact of T2DM on the treatment and management of osteoporosis in order to achieve the best clinical outcome and to ensure the most efficient use of healthcare resources.…”

Section: Discussionsupporting

confidence: 77%

“…Effective management of osteoporotic fractures requires careful evaluation not only of osteoporosis but also of the increasing number of comorbidities that are thought to influence the risk of fractures [4]. Diabetes is emerging as one of the most important comorbidities in terms of its impact on fractures, as suggested by studies in the USA and in Europe [5, 6].…”

Section: Introductionmentioning

confidence: 99%

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Fracture risk and healthcare resource utilization and costs among osteoporosis patients with type 2 diabetes mellitus and without diabetes mellitus in Japan: retrospective analysis of a hospital claims database

Sato

Sugihara³

et al. 2016

BMC Musculoskelet Disord

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BackgroundOsteoporosis, osteoporosis-related fractures, and diabetes are considerable health burdens in Japan. Diabetes in patients with osteoporosis has been reported to be associated with increased fracture risk. This retrospective analysis of a Japanese hospital claims database investigated the real-world effect of type 2 diabetes mellitus (T2DM) on the incidence of clinical fractures, costs, and healthcare resource utilization in patients with osteoporosis and a subgroup of patients prescribed raloxifene.MethodsWomen aged ≥50 years diagnosed with osteoporosis who had a first prescription claim for osteoporosis treatment with a pre-index period ≥12 months and a post-index period of 30 months were selected from a database extract (April 2008-July 2013). Patients prescribed raloxifene were classed as a subgroup. Patients diagnosed with T2DM constituted the T2DM group; all other patients (excluding patients with type 1 diabetes mellitus) constituted the non-diabetes mellitus (non-DM) group. Groups were matched by exact matching, using selected baseline characteristics. Patient demographic and clinical characteristics were compared using chi-squared tests, t-tests, or Wilcoxon rank sum tests. Time to first fracture was examined using Kaplan-Meier survival analysis.ResultsOverall, the T2DM and non-DM groups had 7580 and 7979 patients, respectively; following matching, there were 3273 patients per group. In the raloxifene subgroup, the T2DM and non-DM groups had 668 and 699 patients, respectively; following matching, there were 239 patients per group. At baseline, the T2DM group (overall and raloxifene subgroup) had significantly higher healthcare resource utilization and comorbidities. During the post-index period, a similar pattern was observed in the overall group, even after matching; the T2DM group also had a higher incidence of fracture. In the raloxifene subgroup, after matching, there were no significant differences in fracture incidence or costs and fewer differences in healthcare resource utilization between the T2DM and non-DM groups.ConclusionsThese findings suggest that comorbid T2DM increases fracture incidence in patients with osteoporosis, compared with patients without DM. Increases in fracture incidence were accompanied by greater costs and healthcare resource utilization, which are important considerations for clinical practice in Japan. Further research investigating the use of raloxifene for treatment of osteoporosis with comorbid T2DM may also be warranted.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-1344-9) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Fracture risk and healthcare resource utilization and costs among osteoporosis patients with type 2 diabetes mellitus and without diabetes mellitus in Japan: retrospective analysis of a hospital claims database

Sato

Sugihara³

et al. 2016

BMC Musculoskelet Disord

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“…Various studies have shown that there is an association between comorbidities and the risk of fracture with the most prevalent comorbidities as diabetes and cardiovascular diseases [15,16]. In our study, hypertension, coronary artery disease, and diabetes were found to be commonly occurring comorbidities.…”

Section: Discussionsupporting

confidence: 51%

Study of Drug Utilization Pattern of Calcium, Vitamin D Supplements, and Anti-Osteoporosis Drugs in Patients With Osteoporotic Fracture: A Prospective Cross-Sectional Study

Augustine¹,

Shamrao²,

Basnet³

et al. 2018

Asian J Pharm Clin Res

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Objective: This study was carried out to assess the drug utilization pattern of calcium, Vitamin D supplements, and anti-osteoporosis drugs in patients with osteoporotic fracture in an Indian teaching hospital.Methods: A cross-sectional study was carried out for 6 months in outpatients receiving treatment from the orthopedic department of an Indian teaching hospital. Demographic details, comorbidities, types of fracture, laboratory parameters, and drug therapy were collected from the patient case records who met the study criteria and documented in the data collection form. All the collected details were later analyzed using descriptive statistics.Results: A total of 73 patient’s prescriptions were reviewed, in which 45.2% were male and 54.8% were female. Majority of the patients were in the age group of 50–60 years with mean age of 63.52±11.06 years. Hypertension (27.16%) was the highest comorbidity identified in the study followed by diabetes (18.51%) and coronary artery disease (14.81%). Of the total patients, 65.75% were prescribed with calcium and Vitamin D supplements and 2.73% received bisphosphonates.Conclusion: The study shows the pattern of drug use in elderly with osteoporotic fractures. Since calcium and Vitamin D are vital for treating osteoporotic fractures, adequate monitoring of serum levels of calcium and Vitamin D3 may help to prescribe doses with desired need and safety level.

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“…Osteoporosis is a skeletal disorder characterized by low bone mineral density (BMD) and a compromised bone microarchitecture, which lead to increased risks of bone fragility and fracture [1]. Osteoporosis has become a major healthcare problem worldwide, affecting more than 200 million people [2]. There are gender differences in the occurrence of osteoporosis; postmenopausal women are more likely to have osteoporosis due to the sharp decline of estrogen production [3].…”

Section: Introductionmentioning

confidence: 99%

Case Control Association Study of WNT Signaling Pathway-related Genes and Osteoporosis Risk Among Chinese Postmenopausal Women

Yang

Liu

et al. 2020

Preprint

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Background: The WNT signaling pathway is involved in the regulation of bone homeostasis, and the effects of WNT signaling pathway related genes (WLS, WNT16 and LRP5) on osteoporosis risk among Chinese postmenopausal women is still unknown. Hence, we performed a case-control study to assess the association of WNT signaling pathway related genes and osteoporosis risk.Methods: This study involved 1026 women (515 osteoporosis patients and 511 controls) of postmenopausal age who were randomly sampled from Xi'an 630 Hospital, Shaanxi Province, China. Eleven genetic polymorphisms in WLS (rs2566755, rs12407028, rs2566752 and rs7554551), WNT16 (rs3779381, rs3801387, rs917727 and rs7776725) and LRP5 (rs2291467, rs11228240 and rs12272917) were selected and genotyped using the Agena MassARRAY iPLEX system. The association of the genetic polymorphisms and osteoporosis risk was assessed by odds ratios and 95% confidence intervals. The Multifactor Dimensionality Reduction (MDR) method was conducted to analyze SNP-SNP interaction.Results: We found that LRP5 polymorphisms (rs2291467, rs11228240 and rs12272917) were significantly associated with a decreased risk of osteoporosis in homozygotes, both in recessive and additive models (P < 0.05). Stratification analysis showed that LRP5 polymorphisms (rs2291467, rs11228240 and rs12272917) significantly decreased the osteoporosis risk in the subgroup of BMI ≤ 24 (P < 0.05) and that individuals carrying a heterozygote genotype of WNT16 polymorphisms (rs3779381, rs3801387, rs917727 and rs7776725) had a higher osteoporosis risk in the subgroup of BMI > 24 (P < 0.05). We observed that three blocks (block 1: rs2566755 and rs12407028, block 2: rs3779381, rs3801387, rs917727 and rs7776725, block 3: rs2291467 and rs11228240), Trs2291467Trs11228240 and Crs2291467Crs11228240 had a strong association with a lower risk of osteoporosis. Additionally, MDR analysis revealed that a four-locus model (rs2566752 and rs2566755 in WLS, rs7776725 in WNT16, rs12272917 in LRP5) was significantly associated with osteoporosis risk. Conclusions: Our findings suggested that WLS, WNT16 and LRP5 genetic polymorphisms were associated with osteoporosis risk among Chinese postmenopausal women.

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Lifestyle-Related Metabolic Disorders, Osteoporosis, and Fracture Risk in Asia: A Systematic Review

Abstract: These findings suggest that diabetes is a risk factor for fracture in Asian populations. MetS may be associated with bone loss in Asian men and atherosclerosis associated with increased fractures; however, caution is needed interpreting these findings given limitations in study design.

Cited by 54 publications

References 55 publications

Fracture risk and healthcare resource utilization and costs among osteoporosis patients with type 2 diabetes mellitus and without diabetes mellitus in Japan: retrospective analysis of a hospital claims database

Fracture risk and healthcare resource utilization and costs among osteoporosis patients with type 2 diabetes mellitus and without diabetes mellitus in Japan: retrospective analysis of a hospital claims database

Study of Drug Utilization Pattern of Calcium, Vitamin D Supplements, and Anti-Osteoporosis Drugs in Patients With Osteoporotic Fracture: A Prospective Cross-Sectional Study

Case Control Association Study of WNT Signaling Pathway-related Genes and Osteoporosis Risk Among Chinese Postmenopausal Women

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