Abstract
Summary: Both weight gain and weight loss in type 2 diabetic population were associated with increased risk of hip fracture, while maintaining weight lowered the risk of hip fracture. Regarding the risk of hip fracture, we can propose active monitoring to maintain the weight of type 2 diabetes patients. Introduction: In type 2 diabetes, patients are often asked to control their weight in order to reduce their diabetic morbidity. The American Diabetes Association recommends that diabetic patients conduct high-intensity interventions for regulating diet, physical activity, and behavior to reduce weight, followed by long-term comprehensive weight maintenance programs. Although such weight control attempts are required in diabetic patients, there are few studies on the effect of weight change on hip fracture in this population. We aim to investigate the association between body weight change and the incidence of hip fracture in subjects with type 2 diabetes using large-scale, nationwide cohort data on the Korean population. Materials and methods: A total of 1,447,579 subjects (894,204 men and 553,375 women) > 40 years of age, who were diagnosed with type 2 diabetes, were enrolled in this study. Weight change within 2 years was divided into five categories: from weight loss ≥ 10% to weight gain ≥ 10%. The hazard ratios (HRs) and 95% confidence intervals for the incidence of hip fracture were analyzed, compared with the reference of the stable weight group (weight change < 5%). Results: Among 5 weight change groups, more than 10% weight loss showed the highest HR (HR, 1.605; 95% CI, 1.493 to 1.725), followed by more than 10% weight gain (HR, 1.457; 95% CI, 1.318 to 1.612). The effect of weight change on hip fracture risk was greater in males than in females, and those under 65 years of age were greater than those over 65 years of age. Baseline BMI did not play a role of weight change affecting the risk of hip fracture. The HR for hip fracture of subjects with regular exercise was lower than those without regular exercise. Conclusions: In the type 2 diabetes population, both weight gain and weight loss were significantly associated with a higher risk of hip fracture, whereas maintaining body weight reduced the risk of hip fracture the most.
| Original language | English |
|---|---|
| Pages (from-to) | 1755-1767 |
| Number of pages | 13 |
| Journal | Osteoporosis International |
| Volume | 33 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 2022 |
Bibliographical note
Funding Information:The National Health Insurance Service (NHIS) is a mandatory social medical insurance system run by the Korean government. It is mainly supported by the contributions from the insured and the government subsidy. The NHIS covers approximately 97% of the population, and Medical Aid covers the remaining 3% of the low-income population. All healthcare providers are obliged to treat the insured, and the insured except the low-income group pay contributions monthly. As the NHIS operates on a fee-for-service system to pay healthcare providers, it is mandatory for all healthcare providers to submit the data regarding inpatients and outpatients, identification numbers, primary and secondary diagnoses classified according to the International Classification of Diseases-10th Revision (ICD-10), prescriptions, procedures, date of visits or hospitalization, and medical costs. The NHIS is in charge of collecting insurance contribution, providing health insurance benefits, managing the eligibility of the insured and making the medical service fee contract with representatives of healthcare providers. In addition, the NHIS operates the National Medical Checkup Program, which conducts a biannual standardized medical checkup for all of the insured who are 20 years old or older without copayment. Anthropometric measurements such as height, weight, body mass index (BMI) and waist circumference, systolic and diastolic blood pressure (BP), visual and hearing acuity, and laboratory tests such as fasting plasma glucose (FPG), total cholesterol (TC), serum creatinine, liver enzymes, urinalysis, and estimated glomerular filtration rate (eGFR) are included in the standardized medical checkup. Data on past medical history and health-related behaviors such as smoking status, alcohol consumption, and regular exercise are also obtained through a standardized self-reported questionnaire. Detailed information about the Korean NHIS was previously introduced elsewhere [].
Publisher Copyright:
© 2022, International Osteoporosis Foundation and National Osteoporosis Foundation.
Keywords
- Hip fractures
- Type 2 diabetes
- Weight change
