Resumo

MARTINEZ-LAGUNA, D. et al. Risk of fracture associated with states prior to the diagnosis of diabetes mellitus type 2: nested case-controlled study (DIAFOS cohort). Rev Osteoporos Metab Miner [online]. 2013, vol.5, n.2, pp.73-78. ISSN 2173-2345.  https://dx.doi.org/10.4321/S1889-836X2013000200003.

Backgound: In phases prior to the diagnosis of diabetes mellitus type 2 there is an increased risk of cardiovascular disease, but it is not known if this is the case in relation to the risk of fractures. Objective: To compare the prevalence of fracture in cases of diabetes mellitus and in matched controls. Material and method: Nested case-control study in a population-based cohort. All patients diagnosed with type 2 diabetes in the period 2006-2011 were included, as were, for each of these patients, two control subjects of the same age, gender, and from the same medical centre, without diabetes. Any fractures, cerebro-vascular accidents and ischemic cardiopathy prevalent in these patients were identified using ICD codes 10. The prevalence of osteoporotic, major and hip fractures, and of cardiovascular disease at the time of diagnosis for the diabetic subjects, and on the same date for the matched controls, were calculated. Using conditional logistical regression the odds ratios (OR) were calculated, adjusting for body mass index, smoking, alcoholism, use of statins, cardiovascular disease and diabetic complications. Results: 58,931 diabetic patients and 117,862 controls were identified. At the date of diagnosis the diabetic patients had a higher prevalence of cerebro-vascular accident (4.9% vs 3.5%; p< 0.001) and ischemic cardiopathy (8.1% vs 4.7%; p< 0.001). On the other hand, the prevalence of osteoporotic fracture (2.8% vs 2.7%; p= 0.22), hip fracture (0.4% vs 0.4%; p=0.63) and major fracture (1.5% vs 1.5%; p=0.97) was similar in both groups. The adjusted ORs were: 1.2 (CI 95%: 0.96-1.09), 1.08 (CI 95%: 0.90-1.28), and 0.99 (CI 95%: 0.91-1.09), respectively. Conclusions: The type 2 diabetic patients had a higher prevalence of cardiovascular disease at the time of diagnosis. However, their risk of fracture was similar to the non-diabetic control subjects.

Palavras-chave : diabetes mellitus type 2; osteoporotic fractures; cardiovascular disease; prevalence.

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