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Article: Fracture risks associated with sodium-glucose cotransporter-2 inhibitors in type 2 diabetes patients across eGFR and albuminuria categories: A population-based study in Hong Kong

TitleFracture risks associated with sodium-glucose cotransporter-2 inhibitors in type 2 diabetes patients across eGFR and albuminuria categories: A population-based study in Hong Kong
Authors
KeywordsDiabetes Mellitus, Type 2
Dipeptidyl-Peptidase IV Inhibitors
Fractures, Bone
Osteoporosis
Sodium-Glucose Transporter 2 Inhibitors
Issue Date11-Feb-2023
PublisherElsevier
Citation
Diabetes Research and Clinical Practice, 2023, v. 197 How to Cite?
Abstract

Aims: To evaluate major osteoporotic fracture (MOF) risk among type 2 diabetes patients treated with sodium-glucose cotransporter-2 inhibitors (SGLT2i) across eGFR and albuminuria categories.

Methods: A population-based cohort of type 2 diabetes patients started on SGLT2i or dipeptidyl peptidase-4 inhibitors (DPP4i) during 2007-2020 was identified from Hong Kong Hospital Authority database. One-to-one propensity score matching was applied to match each SGLT2i user with one DPP4i user. The primary outcomes were 180- and 365-day risks of MOF. Cox proportional hazard regression models were used to estimate hazard ratios (HR).

Results: A total of 28,696 patients (14,348 in each group) were included. Over 180-day follow-up, MOF occurred in 25 (0.17 %) SGLT2i users and 24 (0.17 %) DPP4i users (incidence of 4.07 and 3.63/1,000 person-years, respectively). At 365 days, MOF occurred in 43 (0.30 %) SGLT2i users and 44 (0.31 %) DPP4i users (incidence of 4.16 and 3.64/1,000 person-years, respectively). Risks of MOF were comparable between two groups at both 180 days (HR = 1.13, 95 %CI 0.65-1.98, P = 0.67) and 365 days (HR = 1.15, 95 %CI 0.75-1.75, P = 0.52). Subgroup analyses were consistent across age, sex, eGFR, albuminuria, or KDIGO categories.

Conclusions: Our study did not reveal a statistically significant increase in fracture risk with SGLT2i use compared with DPP4i among type 2 diabetes patients, across eGFR and albuminuria categories.


Persistent Identifierhttp://hdl.handle.net/10722/331080
ISSN
2023 Impact Factor: 6.1
2023 SCImago Journal Rankings: 1.340
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLui, David Tak Wai-
dc.contributor.authorWu, Tingting-
dc.contributor.authorTang, Eric Ho Man-
dc.contributor.authorAu, Ivan Chi Ho-
dc.contributor.authorLee, Chi Ho-
dc.contributor.authorWoo, Yu Cho-
dc.contributor.authorTan, Kathryn Choon Beng-
dc.contributor.authorWong, Carlos King Ho-
dc.date.accessioned2023-09-21T06:52:35Z-
dc.date.available2023-09-21T06:52:35Z-
dc.date.issued2023-02-11-
dc.identifier.citationDiabetes Research and Clinical Practice, 2023, v. 197-
dc.identifier.issn0168-8227-
dc.identifier.urihttp://hdl.handle.net/10722/331080-
dc.description.abstract<p><strong>Aims: </strong>To evaluate major osteoporotic fracture (MOF) risk among type 2 diabetes patients treated with sodium-glucose cotransporter-2 inhibitors (SGLT2i) across eGFR and albuminuria categories.</p><p><strong>Methods: </strong>A population-based cohort of type 2 diabetes patients started on SGLT2i or dipeptidyl peptidase-4 inhibitors (DPP4i) during 2007-2020 was identified from Hong Kong Hospital Authority database. One-to-one propensity score matching was applied to match each SGLT2i user with one DPP4i user. The primary outcomes were 180- and 365-day risks of MOF. Cox proportional hazard regression models were used to estimate hazard ratios (HR).</p><p><strong>Results: </strong>A total of 28,696 patients (14,348 in each group) were included. Over 180-day follow-up, MOF occurred in 25 (0.17 %) SGLT2i users and 24 (0.17 %) DPP4i users (incidence of 4.07 and 3.63/1,000 person-years, respectively). At 365 days, MOF occurred in 43 (0.30 %) SGLT2i users and 44 (0.31 %) DPP4i users (incidence of 4.16 and 3.64/1,000 person-years, respectively). Risks of MOF were comparable between two groups at both 180 days (HR = 1.13, 95 %CI 0.65-1.98, P = 0.67) and 365 days (HR = 1.15, 95 %CI 0.75-1.75, P = 0.52). Subgroup analyses were consistent across age, sex, eGFR, albuminuria, or KDIGO categories.</p><p><strong>Conclusions: </strong>Our study did not reveal a statistically significant increase in fracture risk with SGLT2i use compared with DPP4i among type 2 diabetes patients, across eGFR and albuminuria categories.</p>-
dc.languageeng-
dc.publisherElsevier-
dc.relation.ispartofDiabetes Research and Clinical Practice-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectDiabetes Mellitus, Type 2-
dc.subjectDipeptidyl-Peptidase IV Inhibitors-
dc.subjectFractures, Bone-
dc.subjectOsteoporosis-
dc.subjectSodium-Glucose Transporter 2 Inhibitors-
dc.titleFracture risks associated with sodium-glucose cotransporter-2 inhibitors in type 2 diabetes patients across eGFR and albuminuria categories: A population-based study in Hong Kong-
dc.typeArticle-
dc.identifier.doi10.1016/j.diabres.2023.110576-
dc.identifier.scopuseid_2-s2.0-85149208663-
dc.identifier.volume197-
dc.identifier.isiWOS:000990955000001-
dc.identifier.issnl0168-8227-

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