TY - JOUR
T1 - Hip and vertebral fracture risk after initiating antidiabetic drugs in Japanese elderly
T2 - a nationwide study
AU - Tamaki, Junko
AU - Ogawa, Sumito
AU - Fujimori, Kenji
AU - Ishii, Shigeyuki
AU - Nakatoh, Shinichi
AU - Okimoto, Nobukazu
AU - Kamiya, Kuniyasu
AU - Iki, Masayuki
N1 - Funding Information:
Taiju Life Social Welfare Foundation,a 52nd Taiju Life Social Welfare Foundation Medical Research Grant 2019,Junko Tamaki,Japan Osteoporosis Foundation,a Japan Osteoporosis Foundation Grant for Bone Research 2019,Junko Tamaki,Pfizer Japan,a 28th Pfizer Health Research Grant 2019,Junko Tamaki
Funding Information:
The authors thank the personnel of the Osteoporosis Foundation to support the present study. Sources of funding for the present article were as follows: a 52nd Taiju Life Social Welfare Foundation Medical Research Grant 2019, a Japan Osteoporosis Foundation Grant for Bone Research 2019, and a 28th Pfizer Health Research Grant 2019. The funding bodies had no role in either designing the study, collecting and analyzing the, or interpreting the findings, writing the manuscript, or choosing the journal to submit the manuscript.
Funding Information:
The authors thank the personnel of the Osteoporosis Foundation to support the present study. Sources of funding for the present article were as follows: a 52nd Taiju Life Social Welfare Foundation Medical Research Grant 2019, a Japan Osteoporosis Foundation Grant for Bone Research 2019, and a 28th Pfizer Health Research Grant 2019. The funding bodies had no role in either designing the study, collecting and analyzing the, or interpreting the findings, writing the manuscript, or choosing the journal to submit the manuscript.
Publisher Copyright:
© 2022, The Japanese Society Bone and Mineral Research.
PY - 2023/1
Y1 - 2023/1
N2 - Introduction: We aimed to clarify the risks of initiating antidiabetic drugs for fractures using a nationwide health insurance claims database (NDBJ). Materials and Methods: Patients aged ≥ 65 years initiating antidiabetic drugs at the outpatient department were enrolled after a 180-day period without prescribed antidiabetic drugs and followed with during 2012–2018 using NDBJ. The adjusted hazard risks (HRs) of each antidiabetic drug (thiazolidine, alpha-glucosidase inhibitor, dipeptidyl peptidase-4 [DPP-4] inhibitor, sulfonylurea, glinide, and insulin) for fractures compared with biguanide were obtained adjusting for age, gender, polypharmacy, dementia, and the other antidiabetic drugs. Results: The DPP-4 inhibitor was the most often prescribed antidiabetic drug followed by biguanide with prescribed proportions of 71.7% and 12.9%. A total of 4,304 hip fractures and 9,388 vertebral fractures were identified among the 966,700 outpatient participants. Compared with biguanide, insulin, alpha-glucosidase inhibitor, and DPP-4 inhibitor were related to increased hip fracture risks. Vertebral fracture risk was higher in outpatients prescribed with insulin, thiazolidine, and DPP-4 inhibitor compared with biguanide. Patients prescribed insulin for hip and vertebral fractures’ adjusted HRs were 2.17 (95% CI 1.77–2.66) and 1.45 (95% CI 1.24–1.70), respectively. Those prescribed DPP-4 inhibitor for hip and vertebral fractures’ adjusted HRs were 1.27 (95% CI 1.15–1.40) and 1.20 (95% CI 1.12–1.28), respectively. Conclusions: Initiating insulin increased the risk of not only hip fractures but also vertebral fractures. Patients initiating antidiabetic drugs had increased risks of hip and vertebral fractures compared with those initiating biguanide independently for age, gender, polypharmacy, and dementia in the Japanese elderly.
AB - Introduction: We aimed to clarify the risks of initiating antidiabetic drugs for fractures using a nationwide health insurance claims database (NDBJ). Materials and Methods: Patients aged ≥ 65 years initiating antidiabetic drugs at the outpatient department were enrolled after a 180-day period without prescribed antidiabetic drugs and followed with during 2012–2018 using NDBJ. The adjusted hazard risks (HRs) of each antidiabetic drug (thiazolidine, alpha-glucosidase inhibitor, dipeptidyl peptidase-4 [DPP-4] inhibitor, sulfonylurea, glinide, and insulin) for fractures compared with biguanide were obtained adjusting for age, gender, polypharmacy, dementia, and the other antidiabetic drugs. Results: The DPP-4 inhibitor was the most often prescribed antidiabetic drug followed by biguanide with prescribed proportions of 71.7% and 12.9%. A total of 4,304 hip fractures and 9,388 vertebral fractures were identified among the 966,700 outpatient participants. Compared with biguanide, insulin, alpha-glucosidase inhibitor, and DPP-4 inhibitor were related to increased hip fracture risks. Vertebral fracture risk was higher in outpatients prescribed with insulin, thiazolidine, and DPP-4 inhibitor compared with biguanide. Patients prescribed insulin for hip and vertebral fractures’ adjusted HRs were 2.17 (95% CI 1.77–2.66) and 1.45 (95% CI 1.24–1.70), respectively. Those prescribed DPP-4 inhibitor for hip and vertebral fractures’ adjusted HRs were 1.27 (95% CI 1.15–1.40) and 1.20 (95% CI 1.12–1.28), respectively. Conclusions: Initiating insulin increased the risk of not only hip fractures but also vertebral fractures. Patients initiating antidiabetic drugs had increased risks of hip and vertebral fractures compared with those initiating biguanide independently for age, gender, polypharmacy, and dementia in the Japanese elderly.
KW - Antidiabetic drugs
KW - Health insurance claims database
KW - Hip fracture
KW - Nationwide study
KW - Vertebral fracture
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U2 - 10.1007/s00774-022-01372-0
DO - 10.1007/s00774-022-01372-0
M3 - Article
C2 - 36517653
AN - SCOPUS:85143794677
SN - 0914-8779
VL - 41
SP - 29
EP - 40
JO - Journal of Bone and Mineral Metabolism
JF - Journal of Bone and Mineral Metabolism
IS - 1
ER -
