Assessment of Fracture Risk by the FRAX Algorithm in Postmenopausal Korean Women with and without Type 2 Diabetes Mellitus: The Korea National Health and Nutrition Examination Survey 2008-2009

Abstract

Objectives: The aim of this study was to compare the 10-year probability of hip fracture and a major osteoporotic fracture using the FRAX algorithm between postmenopausal Korean women with and without type 2 diabetes mellitus (T2DM).

Materials and Methods: We used data from the Fourth Korea National Health and Nutrition Examination Survey 2008-2009. The measurements of anthropometric parameters and bone mass were obtained using dual energy X-ray absorptiometry (DXA) (Discovery-W, Hologic Inc., USA). Data was available for a total of 1,594 postmenopausal women (1,498 without T2DM and 96 with T2DM) aged 40 to 90 years old. The FRAXⓡ 10-year probability was computed using the algorithm available online at http://www.shef.ac.uk/ FRAX (South Korea version). To compare the 10-year probability of osteoporotic fracture between the groups with and without adjustment for age and weight, a general linear model was used.

Results: Mean 10-year probabilities of fracture were similar between groups for major fractures [diabetic 9.0 (8.0, 10.0, 95% CI) versus non-diabetic 8.1 (7.8, 8.4, 95% CI), P=0.087] and hip fractures [diabetic 3.6 (2.8, 4.3, 95% CI) versus non-diabetic 2.9 (2.7, 3.1, 95% CI), P=0.099]. After adjustment for confounding factors (age and weight), there was also no significant difference between the diabetic and non-diabetic group [major osteoporotic fracture: 8.4 versus 8.1, P=0.563; hip fracture: 3.2 versus 2.9, P=0.320].

Conclusions: FRAX did not reflect higher major osteoporotic and hip fracture risk in Korean T2DM patients. T2DM might be considered for inclusion in future iterations of FRAX.