Summary

This retrospective study investigated the incidence of fracture in 4420 type 1 diabetes (T1DM) patients. Our findings indicate that patients with T1DM have an increased incidence of fractures. Further studies and preventive measures are urgently needed.

Introduction

The aim of this study was to investigate the incidence of fracture in patients with type 1 diabetes mellitus (T1DM).

Methods

This study is based on the German Disease Analyzer database and included 4258 adult individuals with a T1DM diagnosis documented between January 2000 and December 2015 in 1203 general practices in Germany. Individual matching of T1DM and non-diabetic patients was performed. The cumulative incidence of new fractures was shown for up to 10 years after the index date using Kaplan-Meier curves. Cox proportional hazard models (dependent variable: incident fracture) were used to estimate the effect of T1DM on fracture incidence, as well as the effect of predefined variables on fracture incidence.

Results

After 10 years of follow-up, the cumulative fracture incidence was 18.4% for T1DM patients and 9.9% for non-diabetic patients (p < 0.001). A strong association between T1DM and fractures was found (HR, 2.01 (95% CI, 1.70–2.38) p < 0.001) in both female and male patients. Significant differences between T1DM and non-diabetes patients were found in lower leg/ankle, foot and toe, shoulder/upper arm, and rib(s), sternum and thoracic spine fractures. A significant association between higher age and fracture incidence was observed in T1DM patients.

Conclusions

In summary, we found that patients with T1DM have a twofold increased fracture rate compared with healthy controls. Furthermore, fractures were associated with increased age and high HbA1c values.

中文翻译：

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1 型糖尿病患者的骨折发生率——一项对 4420 名患者的回顾性研究。

概括

这项回顾性研究调查了 4420 名 1 型糖尿病 (T1DM) 患者的骨折发生率。我们的研究结果表明，T1DM 患者的骨折发生率增加。迫切需要进一步的研究和预防措施。

介绍

本研究的目的是调查 1 型糖尿病 (T1DM) 患者的骨折发生率。

方法

本研究基于德国疾病分析器数据库，纳入了 2000 年 1 月至 2015 年 12 月期间在德国 1203 次一般实践中记录的 4258 名 T1DM 诊断的成年个体。对 T1DM 和非糖尿病患者进行个体匹配。使用 Kaplan-Meier 曲线显示了索引日期后长达 10 年的新骨折的累积发生率。Cox 比例风险模型（因变量：骨折事件）用于估计 T1DM 对骨折发生率的影响，以及预定义变量对骨折发生率的影响。

结果

经过 10 年的随访，T1DM 患者的累积骨折发生率为 18.4%，非糖尿病患者为 9.9%（p  < 0.001）。 在女性和男性患者中均发现 T1DM 与骨折之间存在强关联（HR，2.01（95% CI，1.70-2.38）p < 0.001）。T1DM 和非糖尿病患者在小腿/脚踝、足部和脚趾、肩部/上臂、肋骨、胸骨和胸椎骨折方面存在显着差异。在 T1DM 患者中观察到较高年龄与骨折发生率之间存在显着关联。

结论

总之，我们发现与健康对照组相比，T1DM 患者的骨折率增加了两倍。此外，骨折与年龄增加和 HbA1c 值升高有关。