高血糖,糖尿病和脆弱性骨折风险:观察性和门德尔随机化研究
Frida Emanuelsson1,2, Shoaib Afzal2,3,4, Niklas R Jørgensen2,5
1Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, Centre of Diagnostic Investigation, Copenhagen, Denmark.
高血糖和糖尿病增加脆弱性骨折的风险. 结合起来,糖尿病和骨折导致死亡风险最高.
科学领域:
- 内分泌学 在内分泌学.
- 骨健康 骨健康 骨健康
- 流行病学 流行病学
背景情况:
- 慢性高血糖是糖尿病的标志,与骨脆弱有关.
- 了解糖尿病,高血糖和骨折风险之间的联系对于患者管理至关重要.
研究的目的:
- 调查高血糖,糖尿病和脆弱性骨折风险之间的联系.
- 为了确定高血糖是否因果导致骨折风险.
- 评估糖尿病和脆弱性骨折对所有原因死亡率的综合影响.
主要方法:
- 观察和门德尔随机化 (MR) 分析使用来自哥本哈根研究和英国生物库 (超过50万个人) 的数据.
- 脆弱性骨折定义为部,脊椎和手臂骨折,通过国家卫生登记处确定.
- 两个样本MR使用了MAGIC.的葡萄糖和HbA1c的总结数据.
主要成果:
- 快速/非快速葡萄糖和HbA1c水平升高与脆弱性骨折风险增加相关 (p<0.001).
- 1型和2型糖尿病患者的脆弱性骨折风险显著增加 (HR分别为1.50和1.22).
- 核磁共振分析支持高血糖和手臂骨折之间存在因果关系;综合糖尿病和骨折史显示80岁 (67%) 的死亡风险最高.
结论:
- 高血糖和糖尿病是脆弱性骨折的确诊危险因素.
- 高血糖症对手臂骨折的因果影响得到了MR分析的支持.
- 糖尿病和先前的脆弱性骨折的结合是死亡风险最高的.
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