TY - JOUR
T1 - Impact of body weight loss from maximum weight on fragility bone fractures in Japanese patients with type 2 diabetes
T2 - The fukuoka diabetes registry
AU - Komorita, Yuji
AU - Iwase, Masanori
AU - Fujii, Hiroki
AU - Ohkuma, Toshiaki
AU - Ide, Hitoshi
AU - Jodai-Kitamura, Tamaki
AU - Sumi, Akiko
AU - Yoshinari, Masahito
AU - Nakamura, Udai
AU - Kang, Dongchon
AU - Kitazono, Takanari
N1 - Funding Information:
Kiyohara, Dr. Yasufumi Doi, Dr. Toshiharu Ninomiya, Dr. Shigenobu Kanba, Dr. Shuzo Kumagai, Dr. Shinako Kaizu, Dr. Yoichiro Hirakawa, Dr. Chisa Matsumoto, and Dr. Chie Kitaoka (Kyushu University); Dr. Nobutaka Tsutsu and Dr. Nobuhiro Sasaki (Fukuoka Red Cross Hospital); Dr. Kiyohide Nunoi, Dr. Yuichi Sato, Dr. Yuji Uchizono, Dr. Ayumi Yamauchi, Dr. Kaori Itoh, and Dr. Chie Kono (St. Mary’s Hospital); Dr. Sakae Nohara, Dr. Hirofumi Imoto, and Dr. Kazushi Amano (Steel Memorial Yawata Hospital); Dr. Daisuke Gotoh, Dr. Toshitaka Himeno, and Dr. Masae Toyonaga (Kyushu Central Hospital); Dr. Noriyasu Shinohara and Dr. Ayako Tsutsumi (Fukuoka Higashi Medical Center); Dr. Yasuhiro Idewaki, Dr. Masahiro Nakano, Dr. Mina Matsuo, Dr. Shoko Morimoto, and Dr. Tomoko Hyodo (Hakujyuji Hospital); Dr. Masae Minami (Clinic Minami Masae); Dr. Miya Wada (Wada Miya Naika Clinic); Dr. Yoshifumi Yokomizo (Yokomizo Naika Clinic); Dr. Masanori Kikuchi and Dr. Yohei Kikuchi (Kikuchi Naika Clinic); Dr. Riku Nomiyama (Suzuki Naika Clinic); Dr. Shin Nakamura (Nakamura Naika Clinic); Dr. Kenji Tashiro (Oshima Eye Hospital); Dr. Mototaka Yoshinari (Yoshinari Naika Clinic); Dr. Kojiro Ichikawa (Fukutsu Naika Clinic); and Dr. Teruo Omae (Hisayama Research Institute For Lifestyle Diseases). The authors also thank clinical research coordinators Chiho Ohba (Hisayama Research Institute For Life-style Diseases) and Kayoko Sekioka and Yoko Nishioka (Kyushu University), as well as those in the administration office: Tomoko Matake (HisayamaResearchInstituteForLifestyleDiseases) and Junko Ishimatsu (Kyushu University). In addition, the authors thank the Edanz Group (www .edanzediting.com/ac) for editing a draft of this manuscript. Funding. The Japan Society for the Promotion of Science KAKENHI (grant numbers 23249037 and 23659353 for M.I. and 16K00861 for H.F.) from the Ministry of Education, Culture, Sports, Science and Technology of Japan supported this work in part. Duality of Interest. No potential conflicts of interest relevant to this article were reported. Author Contributions. Y.K. and M.I. were responsible for the study concept and design. Y.K., M.I.,andH.F.conductedtheanalysis,andT.O.,H.I., T.J.-K., A.S., M.Y., U.N., D.K., and T.K. interpreted data and contributed to the discussion. Y.K. and M.I. drafted the manuscript. All authors participated in critically revising the manuscript and approved the final version. M.I. is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Publisher Copyright:
© 2018 by the American Diabetes Association.
PY - 2018/5/1
Y1 - 2018/5/1
N2 - OBJECTIVE: Thereisgrowingevidencethat weightlossisassociatedwith increasedfracture risk in the general population. As patients with diabetes often lose weight intentionally or unintentionally, we aimed to investigate prospectively the relationship between weight loss from maximum body weight and fracture risk. RESEARCH DESIGN AND METHODS: A total of 4,706 Japanese participants with type 2 diabetes (mean age 66 years), including 2,755 men and 1,951 postmenopausal women, were followed for a median of 5.3 years and were divided accordingto weight loss from maximum weight: <10%, 10% to <20%, 20%to<30%, and ≥30%. The primary outcomes were fragility fractures defined as fractures at sites of hip and spine. RESULTS: During the follow-up period, fragility fractures occurred in 198 participants. The ageand sex-adjusted incidence rates per 1,000 person-years in all participants were 6.4 (<10% weight loss from maximum body weight), 7.8 (10% to <20%), 11.7 (20% to<30%),and19.2(≥30%)(Pfortrend<0.001).Multivariate-adjustedhazardratiosfor fragilityfracturescomparedwithreference(<10%weightloss)were1.48(95%CI0.79-2.77)inthe10%to<20%group,2.23(1.08-4.64)in20%to<30%,and5.20(2.15-12.57) in≥30%in men,and 1.19 (0.78-1.82)in10%to<20%,1.62(0.96-2.73)in20%to<30%, and 1.97 (0.84-4.62) in ≥30% in postmenopausal women. CONCLUSIONS: The current study demonstrates that ≥20% body weight loss from maximum weight is a significant risk factor for fragility fractures in patients with type 2 diabetes, especially in men.
AB - OBJECTIVE: Thereisgrowingevidencethat weightlossisassociatedwith increasedfracture risk in the general population. As patients with diabetes often lose weight intentionally or unintentionally, we aimed to investigate prospectively the relationship between weight loss from maximum body weight and fracture risk. RESEARCH DESIGN AND METHODS: A total of 4,706 Japanese participants with type 2 diabetes (mean age 66 years), including 2,755 men and 1,951 postmenopausal women, were followed for a median of 5.3 years and were divided accordingto weight loss from maximum weight: <10%, 10% to <20%, 20%to<30%, and ≥30%. The primary outcomes were fragility fractures defined as fractures at sites of hip and spine. RESULTS: During the follow-up period, fragility fractures occurred in 198 participants. The ageand sex-adjusted incidence rates per 1,000 person-years in all participants were 6.4 (<10% weight loss from maximum body weight), 7.8 (10% to <20%), 11.7 (20% to<30%),and19.2(≥30%)(Pfortrend<0.001).Multivariate-adjustedhazardratiosfor fragilityfracturescomparedwithreference(<10%weightloss)were1.48(95%CI0.79-2.77)inthe10%to<20%group,2.23(1.08-4.64)in20%to<30%,and5.20(2.15-12.57) in≥30%in men,and 1.19 (0.78-1.82)in10%to<20%,1.62(0.96-2.73)in20%to<30%, and 1.97 (0.84-4.62) in ≥30% in postmenopausal women. CONCLUSIONS: The current study demonstrates that ≥20% body weight loss from maximum weight is a significant risk factor for fragility fractures in patients with type 2 diabetes, especially in men.
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U2 - 10.2337/dc17-2004
DO - 10.2337/dc17-2004
M3 - Article
C2 - 29540432
AN - SCOPUS:85046139503
VL - 41
SP - 1061
EP - 1067
JO - Diabetes Care
JF - Diabetes Care
SN - 1935-5548
IS - 5
ER -