TY - JOUR
T1 - Polypharmacy and bone fracture risk in patients with type 2 diabetes
T2 - The Fukuoka Diabetes Registry
AU - Komorita, Yuji
AU - Ohkuma, Toshiaki
AU - Iwase, Masanori
AU - Fujii, Hiroki
AU - Oku, Yutaro
AU - Higashi, Taiki
AU - Oshiro, Ayaka
AU - Sakamoto, Wakako
AU - Yoshinari, Masahito
AU - Nakamura, Udai
AU - Kitazono, Takanari
N1 - Funding Information:
This work was supported in part by The Japan Society for the Promotion of Science KAKENHI from the Ministry of Education, Culture, Sports, Science and Technology of Japan (grant numbers 20K19663 to Y.K., 19K24229 and 21K11700 to T.O., 23249037 and 23659353 to M.I., and 16K00861 to H.F.), Honjo International Scholarship Foundation (to Y.K.), All Japan Coffee Association (to Y.K.), the Nakatomi Foundation (to Y.K.), the Junior Scientist Development Grant supported by the Japan Diabetes Society (to Y.K. and T.O.), the Lilly Research Grant Program for Bone & Mineral Research from the Japan Osteoporosis Foundation (to Y.K.), Grants for young researchers from Japan Association for Diabetes Education and Care (to T.O.).
Funding Information:
The authors thank Drs. Dongchon Kang, Shinako Ogata-Kaizu, Yoichiro Hirakawa, Tamaki-Jodai Kitamura, Ai Murao-Kimura (Kyushu University), Satoshi Sasaki (The University of Tokyo), Nobuhiro Sasaki (Fukuoka Red Cross Hospital), Kiyohide Nunoi, Yuichi Sato (St. Mary's Hospital), Daisuke Gotoh (Kyushu Central Hospital), Sakae Nohara (Fukuoka Higashi Medical Center), Hitoshi Ide, Yasuhiro Idewaki (Hakujyuji Hospital), Masae Minami (Clinic Minami Masae), Miya Wada (Wada Miya Naika Clinic), Yoshifumi Yokomizo (Yokomizo Naika Clinic), Masanori Kikuchi, Yohei Kikuchi (Kikuchi Naika Clinic), Riku Nomiyama (Suzuki Naika Clinic), Shin Nakamura (Nakamura Naika Clinic), Kenji Tashiro (Oshima Eye Hospital), Mototaka Yoshinari (Yoshinari Naika Clinic), Kojiro Ichikawa (Fukutsu Naika Clinic), Yutaka Kiyohara (Hisayama Research Institute for Lifestyle Diseases). The authors also thank clinical research coordinators Chiho Ohba, Yoko Nishioka (Kyushu University) as well as those in the administration office: Tomoko Matake (Hisayama Research Institute for Lifestyle Diseases), Junko Ishimatsu, and Mitsuko Kojima (Kyushu University). In addition, we thank Edanz Group (https://en-author-services.edanz.com/) for editing a draft of this manuscript.
Publisher Copyright:
© 2021 The Authors
PY - 2021/11
Y1 - 2021/11
N2 - Aims: To prospectively investigate the association between the number of prescribed drugs and the fracture risk in patients with type 2 diabetes. Methods: Japanese participants with type 2 diabetes (n = 4,706; 2,755 men, 1,951 postmenopausal women; mean age, 66 years) were followed for a median of 5.3 years and grouped on the basis of the number of prescribed drugs at baseline. The main outcomes were fractures at any anatomic site and fragility fractures (fractures at hip and spine sites). Results: During follow-up, any fracture occurred in 662 participants. The overall age- and sex-adjusted fracture incidence rates per 1,000 person-years were 21.2 (0–2 drugs), 28.1 (3–5 drugs), 37.7 (6–8 drugs), and 44.0 (≥9 drugs) (p for trend < 0.001). Compared with 0–2 drugs, the multivariate-adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) for fractures were 1.34 (1.07–1.68) for 3–5 drugs, 1.76 (1.37–2.26) for 6–8 drugs, and 1.71 (1.27–2.31) in ≥ 9 drugs. The multivariate-adjusted HR (95% CI) per increment in drugs was 1.05 (1.02–1.08) (p < 0.001). Similar tendencies were observed for fragility fractures. Conclusions: A greater number of prescribed drugs is associated with an increased bone fracture risk in patients with type 2 diabetes.
AB - Aims: To prospectively investigate the association between the number of prescribed drugs and the fracture risk in patients with type 2 diabetes. Methods: Japanese participants with type 2 diabetes (n = 4,706; 2,755 men, 1,951 postmenopausal women; mean age, 66 years) were followed for a median of 5.3 years and grouped on the basis of the number of prescribed drugs at baseline. The main outcomes were fractures at any anatomic site and fragility fractures (fractures at hip and spine sites). Results: During follow-up, any fracture occurred in 662 participants. The overall age- and sex-adjusted fracture incidence rates per 1,000 person-years were 21.2 (0–2 drugs), 28.1 (3–5 drugs), 37.7 (6–8 drugs), and 44.0 (≥9 drugs) (p for trend < 0.001). Compared with 0–2 drugs, the multivariate-adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) for fractures were 1.34 (1.07–1.68) for 3–5 drugs, 1.76 (1.37–2.26) for 6–8 drugs, and 1.71 (1.27–2.31) in ≥ 9 drugs. The multivariate-adjusted HR (95% CI) per increment in drugs was 1.05 (1.02–1.08) (p < 0.001). Similar tendencies were observed for fragility fractures. Conclusions: A greater number of prescribed drugs is associated with an increased bone fracture risk in patients with type 2 diabetes.
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U2 - 10.1016/j.diabres.2021.109097
DO - 10.1016/j.diabres.2021.109097
M3 - Article
C2 - 34678390
AN - SCOPUS:85118492351
VL - 181
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
SN - 0168-8227
M1 - 109097
ER -
