"A simple fragility fracture risk score for type 2 diabetes patients: a derivation, validation, comparison, and risk stratification study"

作者全名："Chuan, Fengning; Gao, Youyuan; Liao, Kun; Ye, Xin; Mei, Mei; Tian, Wenqing; Li, Rong; Zhou, Bo"

作者地址："[Chuan, Fengning; Liao, Kun; Ye, Xin; Mei, Mei; Tian, Wenqing; Li, Rong; Zhou, Bo] Chongqing Med Univ, Dept Endocrinol, Affiliated Hosp 1, Chongqing 400042, Peoples R China; [Chuan, Fengning] Chongqing Univ, Dept Endocrinol, Fuling Hosp, Chongqing 408099, Peoples R China; [Gao, Youyuan] Chongqing Med Univ, Dept Nephrol, Affiliated Hosp 1, Chongqing 400042, Peoples R China; [Zhou, Bo] Chongqing Med Univ, Dept Endocrinol, Affiliated Hosp 1, 1 Friendship Rd, Chongqing 400042, Peoples R China"

通信作者："Zhou, B (通讯作者)，Chongqing Med Univ, Dept Endocrinol, Affiliated Hosp 1, 1 Friendship Rd, Chongqing 400042, Peoples R China."

来源：EUROPEAN JOURNAL OF ENDOCRINOLOGY

ESI学科分类：BIOLOGY & BIOCHEMISTRY

WOS号：WOS:001108592400002

JCR分区：Q1

影响因子：5.3

年份：2023

卷号：189

期号：5

开始页：508

结束页：516

文献类型：Article

关键词：fragility fracture; risk stratification; type 2 diabetes; prediction score

摘要："Objectives The aims of this study were to develop and validate 2 simple scores for stratification of the risks of (1) any fragility (AF) and (2) major osteoporotic fracture (MOF) in type 2 diabetes (T2D) patients; we also compared the performance of these scores with that of the Fracture Risk Assessment Tool (FRAX) and its adjustments.Design and methods In this longitudinal cohort study, 1855 patients with T2D were enrolled from January 2015 to August 2019. Cox proportional hazard regression was used to model the 5-year risk of AF and MOF. These scores were internally validated using a bootstrap resampling method of 1000.Results During a median follow-up of 5 years, 119 (6.42%) cases of AF and 92 (4.96%) cases of MOFs were identified. Both the concordance index (C-index) and calibration plots indicated improved identification performance using the newly established scores. Furthermore, these scores also showed improved outcomes regarding the decision curve analysis (DCA) and area under the curve (AUC) compared to the widely used FRAX and its derivatives. More importantly, these scores successfully separated T2D patients into risk groups according to significant differences in fracture incidence.Conclusions These novel scores enable simple and reliable fracture risk stratification in T2D patients. Future work is needed to validate these findings in external cohort(s)."

基金机构：Chongqing University Fuling Hospital

基金资助正文：We thank all the patients and their families for participating in this study. F.C. is a cotrained postdoctoral fellow by Chongqing Medical University and Chongqing University Fuling Hospital.