Factors associated with fragility fractures in type 2 diabetes: An analysis of the randomised controlled Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study.

Sheu, A; O'Connell, RL; Jenkins, AJ; Tran, T; Drury, PL; Sullivan, DR; Li, L; Colman, P; O'Brien, R; Kesäniemi, YA; Center, JR; White, CP; Keech, AC

Factors associated with fragility fractures in type 2 diabetes: An analysis of the randomised controlled Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study.

Sheu, A O'Connell, RL Jenkins, AJ Tran, T Drury, PL Sullivan, DR Li, L Colman, P O'Brien, R Kesäniemi, YA Center, JR White, CP Keech, AC

Permalink

Publisher:: WILEY
Publication Type:: Journal Article
Citation:: Diabetes Metab Res Rev, 2023, 39, (5), pp. e3631
Issue Date:: 2023-07

Open Access

Copyright Clearance Process

Recently Added
In Progress
Open Access

This item is open access.

Download Published versionAdobe PDF (686.88 kB)

View on publisher's site

View statistics

Full metadata record

Field	Value	Language
dc.contributor.author	Sheu, A
dc.contributor.author	O'Connell, RL
dc.contributor.author	Jenkins, AJ
dc.contributor.author	Tran, T
dc.contributor.author	Drury, PL
dc.contributor.author	Sullivan, DR
dc.contributor.author	Li, L
dc.contributor.author	Colman, P
dc.contributor.author	O'Brien, R
dc.contributor.author	Kesäniemi, YA
dc.contributor.author	Center, JR
dc.contributor.author	White, CP
dc.contributor.author	Keech, AC
dc.date.accessioned	2025-01-07T05:07:55Z
dc.date.available	2023-02-25
dc.date.available	2025-01-07T05:07:55Z
dc.date.issued	2023-07
dc.identifier.citation	Diabetes Metab Res Rev, 2023, 39, (5), pp. e3631
dc.identifier.issn	1520-7552
dc.identifier.issn	1520-7560
dc.identifier.uri	http://hdl.handle.net/10453/183090
dc.description.abstract	AIMS: Fracture risk is elevated in some type 2 diabetes patients. Bone fragility may be associated with more clinically severe type 2 diabetes, although prospective studies are lacking. It is unknown which diabetes-related characteristics are independently associated with fracture risk. In this post-hoc analysis of fracture data from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial (ISRCTN#64783481), we hypothesised that diabetic microvascular complications are associated with bone fragility. MATERIALS AND METHODS: The FIELD trial randomly assigned 9795 type 2 diabetes participants (aged 50-75 years) to receive oral co-micronised fenofibrate 200 mg (n = 4895) or placebo (n = 4900) daily for a median of 5 years. We used Cox proportional hazards models to identify baseline sex-specific diabetes-related parameters independently associated with incident fractures. RESULTS: Over 49,470 person-years, 137/6138 men experienced 141 fractures and 143/3657 women experienced 145 fractures; incidence rates for the first fracture of 4∙4 (95% CI 3∙8-5∙2) and 7∙7 per 1000 person-years (95% CI 6∙5-9∙1), respectively. Fenofibrate had no effect on fracture outcomes. In men, baseline macrovascular disease (HR 1∙52, 95% CI 1∙05-2∙21, p = 0∙03), insulin use (HR 1∙62, HR 1∙03-2∙55, p = 0∙03), and HDL-cholesterol (HR 2∙20, 95% CI 1∙11-4∙36, p = 0∙02) were independently associated with fracture. In women, independent risk factors included baseline peripheral neuropathy (HR 2∙04, 95% CI 1∙16-3∙59, p = 0∙01) and insulin use (HR 1∙55, 95% CI 1∙02-2∙33, p = 0∙04). CONCLUSIONS: Insulin use and sex-specific complications (in men, macrovascular disease; in women, neuropathy) are independently associated with fragility fractures in adults with type 2 diabetes.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	WILEY
dc.relation.ispartof	Diabetes Metab Res Rev
dc.relation.isbasedon	10.1002/dmrr.3631
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1103 Clinical Sciences
dc.subject.classification	Endocrinology & Metabolism
dc.subject.classification	3202 Clinical sciences
dc.subject.mesh	Adult
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Male
dc.subject.mesh	Diabetes Complications
dc.subject.mesh	Diabetes Mellitus, Type 2
dc.subject.mesh	Fenofibrate
dc.subject.mesh	Fractures, Bone
dc.subject.mesh	Insulins
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Risk Factors
dc.subject.mesh	Humans
dc.subject.mesh	Diabetes Mellitus, Type 2
dc.subject.mesh	Diabetes Complications
dc.subject.mesh	Risk Factors
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Adult
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Fractures, Bone
dc.subject.mesh	Fenofibrate
dc.subject.mesh	Insulins
dc.subject.mesh	Adult
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Male
dc.subject.mesh	Diabetes Complications
dc.subject.mesh	Diabetes Mellitus, Type 2
dc.subject.mesh	Fenofibrate
dc.subject.mesh	Fractures, Bone
dc.subject.mesh	Insulins
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Risk Factors
dc.title	Factors associated with fragility fractures in type 2 diabetes: An analysis of the randomised controlled Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study.
dc.type	Journal Article
utslib.citation.volume	39
utslib.location.activity	England
utslib.for	1103 Clinical Sciences
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	University of Technology Sydney/Faculty of Engineering and Information Technology/School of Biomedical Engineering
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.date.updated	2025-01-07T05:07:53Z
pubs.issue	5
pubs.publication-status	Published
pubs.volume	39
utslib.citation.issue	5

Abstract:

AIMS: Fracture risk is elevated in some type 2 diabetes patients. Bone fragility may be associated with more clinically severe type 2 diabetes, although prospective studies are lacking. It is unknown which diabetes-related characteristics are independently associated with fracture risk. In this post-hoc analysis of fracture data from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial (ISRCTN#64783481), we hypothesised that diabetic microvascular complications are associated with bone fragility. MATERIALS AND METHODS: The FIELD trial randomly assigned 9795 type 2 diabetes participants (aged 50-75 years) to receive oral co-micronised fenofibrate 200 mg (n = 4895) or placebo (n = 4900) daily for a median of 5 years. We used Cox proportional hazards models to identify baseline sex-specific diabetes-related parameters independently associated with incident fractures. RESULTS: Over 49,470 person-years, 137/6138 men experienced 141 fractures and 143/3657 women experienced 145 fractures; incidence rates for the first fracture of 4∙4 (95% CI 3∙8-5∙2) and 7∙7 per 1000 person-years (95% CI 6∙5-9∙1), respectively. Fenofibrate had no effect on fracture outcomes. In men, baseline macrovascular disease (HR 1∙52, 95% CI 1∙05-2∙21, p = 0∙03), insulin use (HR 1∙62, HR 1∙03-2∙55, p = 0∙03), and HDL-cholesterol (HR 2∙20, 95% CI 1∙11-4∙36, p = 0∙02) were independently associated with fracture. In women, independent risk factors included baseline peripheral neuropathy (HR 2∙04, 95% CI 1∙16-3∙59, p = 0∙01) and insulin use (HR 1∙55, 95% CI 1∙02-2∙33, p = 0∙04). CONCLUSIONS: Insulin use and sex-specific complications (in men, macrovascular disease; in women, neuropathy) are independently associated with fragility fractures in adults with type 2 diabetes.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/183090