Impact of body weight loss from maximum weight on fragility bone fractures in Japanese patients with type 2 diabetes: The fukuoka diabetes registry

Abstract

OBJECTIVE: Thereisgrowingevidencethat weightlossisassociatedwith increasedfracture risk in the general population. As patients with diabetes often lose weight intentionally or unintentionally, we aimed to investigate prospectively the relationship between weight loss from maximum body weight and fracture risk. RESEARCH DESIGN AND METHODS: A total of 4,706 Japanese participants with type 2 diabetes (mean age 66 years), including 2,755 men and 1,951 postmenopausal women, were followed for a median of 5.3 years and were divided accordingto weight loss from maximum weight: <10%, 10% to <20%, 20%to<30%, and ≥30%. The primary outcomes were fragility fractures defined as fractures at sites of hip and spine. RESULTS: During the follow-up period, fragility fractures occurred in 198 participants. The ageand sex-adjusted incidence rates per 1,000 person-years in all participants were 6.4 (<10% weight loss from maximum body weight), 7.8 (10% to <20%), 11.7 (20% to<30%),and19.2(≥30%)(Pfortrend<0.001).Multivariate-adjustedhazardratiosfor fragilityfracturescomparedwithreference(<10%weightloss)were1.48(95%CI0.79-2.77)inthe10%to<20%group,2.23(1.08-4.64)in20%to<30%,and5.20(2.15-12.57) in≥30%in men,and 1.19 (0.78-1.82)in10%to<20%,1.62(0.96-2.73)in20%to<30%, and 1.97 (0.84-4.62) in ≥30% in postmenopausal women. CONCLUSIONS: The current study demonstrates that ≥20% body weight loss from maximum weight is a significant risk factor for fragility fractures in patients with type 2 diabetes, especially in men.