BACKGROUND Elderly patients with type 2 diabetes mellitus (T2DM) experience fractures more frequently than elderly individuals without diabetes. Fractures requiring hospitalization greatly affect quality of life, and although elderly patients with T2DM have several risk factors associated with fractures, only a few studies have evaluated these in detail in the Asian population. We conducted a retrospective study of elderly patients with T2DM for evaluating factors associated with fracture risk. METHODS We conducted a retrospective study using electronic medical records (EMR) of patients aged ≥65 years with T2DM who were admitted to a public general medical institute in central Tokyo, Japan. We evaluated factors associated with fractures necessitating hospitalization in elderly patients with T2DM characteristics and hypoglycemic agent use. Factors associated with fracture risk were identified using multivariable logistic regression analysis. RESULTS A total of 2,112 elderly patients (age ≥ 65 years) with T2DM were analyzed. Among them, 69 (3.3%) patients had been hospitalized for fractures. Factors associated with fractures were female sex (OR, 3.46), eGFR < 60 ml / min / 1.73 m2 (OR, 0.55), and thiazolidine use (OR, 4.28). Further, a separate analysis based on sex revealed that the use of thiazolidines was significantly associated with fracture risk in both sexes. CONCLUSIONS In elderly patients with T2DM, the key factor associated with fractures was the use of thiazolidines in both males and females. In this study, the use of thiazolidines was newly identified as a factor which increased the risk of fractures requiring hospitalization in elderly males. The study findings should be considered when hypoglycemic agents are selected for treating elderly patients with T2DM. Information bias, selection bias, and the effect of concomitant drugs may be the underlying reasons for why eGFR < 60 mL / min / 1.73 m2 reduced the fracture risk. However, details are unknown, and additional investigations are needed.

中文翻译：

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研究老年2型糖尿病患者骨折的风险：一项回顾性研究。

背景技术2型糖尿病（T2DM）的老年患者比没有糖尿病的老年患者更容易发生骨折。需要住院治疗的骨折极大地影响了生活质量，尽管老年T2DM患者具有多种与骨折相关的危险因素，但只有少数研究对亚洲人群进行了详细评估。我们对老年T2DM患者进行了回顾性研究，以评估与骨折风险相关的因素。方法我们使用电子病历（EMR）对日本东京中部一家公共综合医学机构收治的≥65岁的T2DM患者进行了回顾性研究。我们评估了与骨折相关的因素，这些骨折需要对具有T2DM特征和使用降糖药的老年患者进行住院治疗。使用多因素逻辑回归分析确定与骨折风险相关的因素。结果共分析了2112例T2DM老年患者（年龄≥65岁）。其中，有69名（3.3％）患者因骨折而住院。与骨折相关的因素是女性（OR，3.46），eGFR <60 ml / min / 1.73 m2（OR，0.55）和噻唑烷的使用（OR，4.28）。此外，基于性别的另一项分析显示，噻唑烷类药物的使用与两性骨折风险显着相关。结论在老年T2DM患者中，与骨折有关的关键因素是男性和女性均使用噻唑烷。在这项研究中，新发现使用噻唑烷是增加老年男性需要住院的骨折风险的因素。选择降糖药治疗老年T2DM患者时应考虑研究结果。信息偏倚，选择偏倚以及伴随药物的作用可能是eGFR <60 mL / min / 1.73 m2降低骨折风险的根本原因。但是，细节未知，因此需要进行其他调查。