Type 2 diabetes mellitus (T2DM) is associated with an excess risk of fractures and overall mortality. This study compared hip fracture and post-hip fracture mortality in T2DM and non-diabetic subjects. The salient findings are that subjects in T2DM are at higher risk of dying after suffering a hip fracture. INTRODUCTION Previous research suggests that individuals with T2DM are at an excess risk of both fractures and overall mortality, but their combined effect is unknown. Using multi-state cohort analyses, we estimate the association between T2DM and the transition to hip fracture, post-hip fracture mortality, and hip fracture-free all-cause death. METHODS Population-based cohort from Catalonia, Spain, including all individuals aged 65 to 80 years with a recorded diagnosis of T2DM on 1 January 2006; and non-T2DM matched (up to 2:1) by year of birth, gender, and primary care practice. RESULTS A total of 44,802 T2DM and 81,233 matched controls (53% women, mean age 72 years old) were followed for a median of 8 years: 23,818 died without fracturing and 3317 broke a hip, of whom 838 subsequently died. Adjusted HRs for hip fracture-free mortality were 1.32 (95% CI 1.28 to 1.37) for men and 1.72 (95% CI 1.65 to 1.79) for women. HRs for hip fracture were 1.24 (95% CI 1.08 to 1.43) and 1.48 (95% CI 1.36 to 1.60), whilst HRs for post-hip fracture mortality were 1.28 (95% CI 1.02 to 1.60) and 1.57 (95% CI 1.31 to 1.88) in men and women, respectively. CONCLUSION T2DM individuals are at increased risk of hip fracture, post-hip fracture mortality, and hip fracture-free death. After adjustment, T2DM men were at a 28% higher risk of dying after suffering a hip fracture and women had 57% excess risk of post-hip fracture mortality.

中文翻译：

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2 型糖尿病、髋部骨折和髋部骨折后死亡率之间的关联：多状态队列分析。

2 型糖尿病 (T2DM) 与骨折和总体死亡率过高的风险相关。本研究比较了 T2DM 和非糖尿病受试者的髋部骨折和髋部骨折后死亡率。显着的发现是，T2DM 患者在髋部骨折后死亡的风险更高。引言 以前的研究表明，患有 T2DM 的个体发生骨折和总体死亡率的风险都很高，但它们的综合影响尚不清楚。使用多状态队列分析，我们估计了 T2DM 与向髋部骨折的转变、髋部骨折后死亡率和无髋部骨折全因死亡之间的关联。方法 来自西班牙加泰罗尼亚的基于人群的队列，包括 2006 年 1 月 1 日被诊断为 T2DM 的所有年龄在 65 至 80 岁之间的个体；和非 T2DM 匹配（最多 2 个：1) 按出生年份、性别和初级保健实践。结果 总共对 44,802 名 T2DM 和 81,233 名匹配的对照（53% 为女性，平均年龄 72 岁）进行了中位 8 年的随访：23,818 人在没有骨折的情况下死亡，3317 人髋部骨折，其中 838 人随后死亡。男性无髋部骨折死亡率的调整 HR 为 1.32（95% CI 1.28 至 1.37），女性为 1.72（95% CI 1.65 至 1.79）。髋部骨折的 HR 为 1.24（95% CI 1.08 至 1.43）和 1.48（95% CI 1.36 至 1.60），而髋部骨折后死亡率的 HR 为 1.28（95% CI 1.02 至 1.60）和 1.57（95% CI 1.31）到 1.88) 分别在男性和女性中。结论 T2DM 个体髋部骨折、髋部骨折后死亡率和无髋部骨折死亡的风险增加。调整后，