title: Associations with fracture in patients with diabetes: a nested case-control study.
abstract: OBJECTIVE
  Diabetes mellitus is associated with an increased risk of fractures, which is not fully explained by bone mineral density and common risk factors. The aim of this study is to investigate the association of medication and biochemical markers on the risk of fracture in a diabetes population.
  
  
  METHODS
  A nested case-control study was conducted based on Danish diabetes patients from The Danish National Hospital Discharge Registry.
  
  
  METHODS
  The cases of the study were diabetes patients with a fracture (n=24,349), and controls were diabetes patients with no fracture (n=132,349). A total of 2627 diabetes patients were available for an analysis of patient characteristics, comorbidities, biochemical parameters and drug usage.
  
  
  RESULTS
  Age (OR=1.02, 95% CI 1.01 to 1.04), diabetes duration (OR=1.06, 95% CI 1.02 to 1.09), a diagnosis of previous fracture (OR=2.20, 95% CI 1.55 to 3.11), an alcohol-related diagnosis (OR=2.94, 95% CI 1.76 to 4.91), total cholesterol level (OR=2.50, 95% CI 1.20 to 5.21) and the usage of antiepileptics (OR=2.12, 95% CI 1.39 to 3.59) all increased the odds of fracture. Low-density lipoprotein cholesterol levels decreased the odds of fracture (OR =0.34, 95% CI 0.16 to 0.74), where the level of 3.04-5.96 mmol/L was optimal with regard to fracture risk.
  
  
  CONCLUSIONS
  Low-density lipoprotein cholesterol may improve our understanding of fractures in diabetes patients, and it may be added to current fracture risk models in diabetes patients.
authors.affiliation: Department of Endocrinology and Internal Medicine (MEA), Aarhus University Hospital THG, Aarhus, Denmark Clinical Institute, Aalborg University, Aalborg, Denmark.
authors.forename: Jakob
authors.initials: J
authors.lastname: Starup-Linde
authors.affiliation: Department of Endocrinology and Internal Medicine (MEA), Aarhus University Hospital THG, Aarhus, Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Gregersen
authors.affiliation: Clinical Institute, Aalborg University, Aalborg, Denmark Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Vestergaard
mesh_terms: D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking; D000927:Anticonvulsants / Q000627:therapeutic use; D015519:Bone Density; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000927:Anticonvulsants; D008077:Lipoproteins, LDL; D002784:Cholesterol
keywords: DIABETES & ENDOCRINOLOGY