TY - JOUR
T1 - Assessment of fracture risk by the FRAX algorithm in men and women with and without type 2 diabetes mellitus
T2 - A cross-sectional study
AU - Carnevale, Vincenzo
AU - Morano, Susanna
AU - Fontana, Andrea
AU - Annese, Maria Antonietta
AU - Fallarino, Mara
AU - Filardi, Tiziana
AU - Copetti, Massimiliano
AU - Pellegrini, Fabio
AU - Romagnoli, Elisabetta
AU - Eller-Vainicher, Cristina
AU - Zhukouskaya, Volha V.
AU - Chiodini, Iacopo
AU - D'Amico, Graziella
PY - 2014
Y1 - 2014
N2 - Background: The FRAX algorithm is a diffuse tool to assess fracture risk, but it has not been clinically applied in European patients with diabetes. We investigated FRAX-estimated fracture risk in patients with type 2 diabetes mellitus (DM), compared with concomitantly enrolled control subjects. Methods: In our multicentric cross-sectional study, we assessed the FRAX scores of 974 DM and 777 control subjects from three Italian diabetes outpatient clinics, and in DM. We tested the association between parameters and complications of the disease and FRAX scores. Results: DM had significantly lower FRAX-estimated probability of both major osteoporotic fracture (MOF) and hip fracture (HF) than control subjects (6.35±5.07% versus 7.75±6.93%, p1c and hypoglycaemia are significantly associated with FRAX scores; gender-specific regression models differed. Among DM, the tree-based regression (classification and regression tree (CART)) analysis identified groups of patients with different mean FRAX scores. In female DM aged >65years with or without obesity, MOF>20% was found in 5.66% and 13.53% and HF>3% in 40.57% and 63.91% of patients, respectively. Conclusions: Patients with DM had mean FRAX scores lower than control subjects, despite the higher number of previous fractures. Some features and complications of DM did associate with FRAX scores. Among DM patients, the CART analysis identified subgroups with higher FRAX scores. However, despite its potential utility, concerns still remain for using FRAX in DM patients.
AB - Background: The FRAX algorithm is a diffuse tool to assess fracture risk, but it has not been clinically applied in European patients with diabetes. We investigated FRAX-estimated fracture risk in patients with type 2 diabetes mellitus (DM), compared with concomitantly enrolled control subjects. Methods: In our multicentric cross-sectional study, we assessed the FRAX scores of 974 DM and 777 control subjects from three Italian diabetes outpatient clinics, and in DM. We tested the association between parameters and complications of the disease and FRAX scores. Results: DM had significantly lower FRAX-estimated probability of both major osteoporotic fracture (MOF) and hip fracture (HF) than control subjects (6.35±5.07% versus 7.75±6.93%, p1c and hypoglycaemia are significantly associated with FRAX scores; gender-specific regression models differed. Among DM, the tree-based regression (classification and regression tree (CART)) analysis identified groups of patients with different mean FRAX scores. In female DM aged >65years with or without obesity, MOF>20% was found in 5.66% and 13.53% and HF>3% in 40.57% and 63.91% of patients, respectively. Conclusions: Patients with DM had mean FRAX scores lower than control subjects, despite the higher number of previous fractures. Some features and complications of DM did associate with FRAX scores. Among DM patients, the CART analysis identified subgroups with higher FRAX scores. However, despite its potential utility, concerns still remain for using FRAX in DM patients.
KW - Classification and regression tree
KW - Fractures
KW - FRAX
KW - Type 2 diabetes
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U2 - 10.1002/dmrr.2497
DO - 10.1002/dmrr.2497
M3 - Article
C2 - 24420974
AN - SCOPUS:84897937425
VL - 30
SP - 313
EP - 322
JO - Diabetes/Metabolism Research and Reviews
JF - Diabetes/Metabolism Research and Reviews
SN - 1520-7552
IS - 4
ER -