Increased risk of hip fractures in Korean patients with type 2 diabetes: a 6-year nationwide population-based study
Se Hwa Kim1,2, Yoo Mee Kim1,3, Jeong Seon Yoo1
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Simgokro 100gil 25, Seo-gu, Incheon Metropolitan City, 404-834, South Korea.
Abstract:
We compared the incidence and risk of hip fractures in Korean patients with type 2 diabetes and non-diabetic subjects in a nationwide population-based study. The study included 17,110 patients diagnosed with type 2 diabetes in 2004 and 34,220 randomly selected age- and sex-matched control subjects drawn from the Korean National Health Insurance Research database. Fracture events occurring between 2004 and 2010 were identified from medical claims data. The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for fractures associated with diabetes were calculated. A total of 3855 fractures of any type (3029 in females and 826 in males) and 493 hip fractures (353 in females and 140 in males) were observed in 51,330 subjects over a 6-year follow-up period. The risk of hip fractures was significantly higher in female (HR 1.73; 95% CI 1.38-2.16) and male (HR 1.84; 95% CI 1.29-2.63) diabetics than in non-diabetic controls after adjusting for multiple confounders. Stratification by age revealed that the adjusted HR for hip fractures was highest in diabetic patients aged 50-64 years (HR 2.54 in females and 2.70 in males) and decreased with increasing age. The risk of other fractures did not differ between the groups. Korean males and females with type 2 diabetes are at an increased risk of hip fractures compared with non-diabetic individuals. Osteoporosis assessments and fracture prevention strategies are necessary for Koreans with type 2 diabetes.
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