10-year risk of fractures (FRAX) in people with diabetes type 2


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Abstract

Aim. To study indicators of bone mineral densit (BMD) and trabecular bone score (TBS) and to reveal the 10-year fracture risk (FRAX®) taking into account the data obtained in persons with type 2 diabetes (DM2). Materials and methods. A clinical study of the type of case - control. The study included 122 people with and without DM2. All persons were: questionnaires, anthropometry, densitometry, determination of TBS and fracture risk on the FRAX®. Results and discussion. Persons with DM2 who underwent a fracture had lower T-score values in all areas except the spine, unlike those with DM2, but without fracture. However, persons with DM2 had a fracture at high values of T-score in vertebrae and hips in comparison with persons without DM. Using the TBS, we did not get a significant difference in any of the examined groups. We also found no differences in the risk of recurrent fractures among women with and without DM2 using FRAX® without densitometry and FRAX® adjusted for TBS. The values of FRAX® by T-score in the group of persons with DM with fractures were significantly lower (p=0.029 for major fractures, p=0.024 for hip fractures) than in persons without DM with fractures. Conclusion. Persons with DM2 and fractures have higher BMD values, lower than the FRAX fracture risk values adjusted for the T-score, do not differ significantly in TBS, which determines the difficulties in diagnosis, the need to find additional methods for early diagnosis of increased fracture risk in patients with DM2.

About the authors

E S Mazurenko

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopaedics; Research Institute of Internal and Preventive Medicine - Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences

Email: poltorackayaes@gmail.com
врач-эндокринолог ФГБУ «ННИИТО им. Я.Л. Цивьяна»; ORCID: 0000-0003-3351-1993 Novosibirsk, Russia

S K Malutina

Research Institute of Internal and Preventive Medicine - Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences

д.м.н. проф., руководитель лаб. этиопатогенеза и клиники внутренних заболеваний НИИТПМ - филиала ИЦиГ СО РАН; ORCID: 0000-0001-6539-0466 Novosibirsk, Russia

L V Shcherbakova

Research Institute of Internal and Preventive Medicine - Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences

с.н.с. НИИТПМ - филиала ИЦиГ СО РАН; ORCID:0000-0001-9270-9188 Novosibirsk, Russia

Yu V Hrapova

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopaedics

к.м.н., врач лучевой диагностики ФГБУ «ННИИТО им. Я.Л. Цивьяна»; ORCID: 0000-0001-5753-4570 Novosibirsk, Russia

M P Isaeva

Novosibirsk State University

студентка ФГАОУ ВО «НГУ»; ORCID: 0000-0002-9963-6783 Novosibirsk, Russia

O D Rymar

Novosibirsk State University

д.м.н., зав. лаб. клинико-популяционных и профилактических исследований терапевтических и эндокринных заболеваний, в.н.с. НИИТПМ - филиала ИЦиГ СО РАН; ORCID: 0000-0003-4095-0169 Novosibirsk, Russia

References

  1. Ogurtsova K, da Rocha Fernandes J.D, Huang Y, et al. IDF diabetes atlas: global estimates for the prevalence of diabetes 2015-2040. Diabetes Res Clin Pract. 2017;128:40-50. doi: 10.1016/j.diabres.2017.03.024
  2. Dawson-Hughes B, Tosteson A.N, Melton L.J, et al. Implications of absolute fracture risk assessment for osteoporosis practice guidelines in the USA. Osteoporos Int. 2008;22;19(4):449-58. doi: 10.1007/s00198-008-0559-5
  3. Vestergaard P, Rejnmark L, Mosekilde L. Diabetes and its complications and their relationship with risk of fractures in type 1 and type 2 diabetes. Calcif Tissue Int. 2009 Jan;84(1):45-55. doi: 10.1007/s00223-008-9195-5
  4. Kanis J.A, on behalf of the WHO Scientific Group. Assessment of osteoporosis at the primary health - care level. Technical Report. WHO Collaboraiting Centre, University of Sheffield, UK, 2008.
  5. Мельниченко Г.А., Белая Ж.Е., Рожинская Л.Я. и др. Федеральные клинические рекомендации по диагностике, лечению и профилактике остеопороза. Проблемы эндокринологии. 2017;63(6):392-426. doi: 10.14341/probl2017636392-426
  6. Bousson V, Bergot C, Sutter B, et al. Trabecular bone score (TBS): available knowledge, clinical relevance, and future prospects. Osteoporosis Int. 2011;23(5):1489-501. doi: 10.1007/s00198-011-1824-6
  7. Лесняк О.М., ред. Остеопороз: руководство для врачей. М.: ГЭОТАР-Медиа, 2016.
  8. Barrett-Connor E, Sajjan S, Siris E, et al. Wrist fracture as a predictor of future fractures in young and older postmenopausal women: results from the National Osteoporosis Risk Assessment (NORA). Osteoporosis Int. 2008;19(5):607-13.
  9. Lipscombe L.L, Jamal S.A, Booth G.L, Hawker G.A. The Risk of Hip Fractures in Older Individuals with Diabetes: A populationbased study. Diabetes Care. 2007 Apr;30(4):835-41. doi: 10.2337/dc06-1851
  10. Fan Y, Wei F, Lang Y, Liu Y. Diabetes mellitus and risk of hip fractures: a meta - analysis. Osteoporos Int. 2016;27(1):219-28. doi: 10.1007/s00198-015-3279-7
  11. Schwartz A.V, Vittinghoff E, Bauer D.C, Hillier T.A, et al. Study of Osteoporotic Fractures Research Group, Osteoporotic Fractures in Men Research Group, Health, Aging, and Body Composition Research Group. Association of BMD and FRAX score with risk of fracture in older adults with type 2 diabetes. JAMA. 2011;305:2184-92. doi: 10.1001/jama.2011.715
  12. Ferrari S.L, Abrahamsen B, Napoli N, Akesson K, et al. Diagnosis and management of bone fragility in diabetes: an emerging challenge. Osteoporos Int. 2018 Jul 31. doi: 10.1007/s00198-018-4650-2
  13. Mc Closkey E.V, Oden A, Harvey N.C, et al. A meta - analysis of trabecular bone score in fracture risk prediction and its relationship to FRAX. J Bone Miner Res. 2016;31:940-8. doi: 10.1002/jbmr.2734
  14. Leslie W.D, Aubry-Rozier B, Lamy O, et al. TBS (trabecular bone score) and diabetes - related fracture risk. J Clin Endocrinol Metab. 2013;98:602-9. doi: 10.1210/jc.2012-3118
  15. Ялочкина Т.О., Белая Ж.Е., Чернова Т.О. и др. Использование ТКИ для повышения чувствительности оценки вероятности переломов (FRAX) у пациентов с сахарным диабетом 2 типа. Ожирение и метаболизм. 2017;14(4):67-72. doi: 10.14341/omet2017467-72

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