TYPE 2 DIABETES AND FRACTURE RISK IN OSTEOPOROTIC POSTMENOPAUSAL WOMEN: A CHINESE COHORT STUDY
Author(s)
Mengyao Xue, MSc1, Nan Peng, PhD2, guoxian Lu, MSc1, ruolan wei, MSc1, Dongning Yao, PhD1.
1School of Pharmacy, Nanjing Medical University, Nanjing, China, 2School of Pharmaceutical Science and Technology,Tianjin University, Tianjin, China.
1School of Pharmacy, Nanjing Medical University, Nanjing, China, 2School of Pharmaceutical Science and Technology,Tianjin University, Tianjin, China.
OBJECTIVES: Osteoporosis and type 2 diabetes mellitus (T2DM) are common chronic conditions and frequently coexist in clinical practice. Osteoporotic fractures are associated with increased mortality, impaired quality of life, and substantial healthcare burden. Although T2DM has been associated with an increased risk of fracture, its impact among patients with established osteoporosis remains insufficiently understood. This study aimed to evaluate the association between T2DM and fracture risk among postmenopausal women with osteoporosis.
METHODS: Postmenopausal women diagnosed with osteoporosis and receiving anti‑osteoporotic medication between January 2019 and October 2025 were enrolled. Patients were classified into the DM group and non‑DM group according to whether T2DM was diagnosed before enrollment. Propensity score matching was used to balance baseline characteristics between groups. The primary outcome was composite fracture, and secondary outcomes included hip fracture, vertebral fracture, and non‑hip non‑vertebral fracture. Cumulative incidence was estimated using the Kaplan-Meier method, and Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
RESULTS: A total of 434,627 postmenopausal women with osteoporosis were included, of whom 106,591 had T2DM and 328,036 did not. After propensity score matching, compared with the non-DM group, the DM group had significantly higher risks of composite fracture (HR = 1.30, 95% CI: 1.26-1.33), hip fracture (HR = 1.64, 95% CI: 1.52-1.77), vertebral fracture (HR = 1.18, 95% CI: 1.11-1.25), and non-hip non-vertebral fracture (HR = 1.34, 95% CI: 1.29-1.40).
CONCLUSIONS: Among postmenopausal women with osteoporosis, coexisting T2DM was associated with an increased risk of overall and site-specific fractures, particularly hip fracture. These findings suggest that fracture prevention in patients with osteoporosis should consider the additional risk associated with T2DM and follow-up care in this high-risk population.
METHODS: Postmenopausal women diagnosed with osteoporosis and receiving anti‑osteoporotic medication between January 2019 and October 2025 were enrolled. Patients were classified into the DM group and non‑DM group according to whether T2DM was diagnosed before enrollment. Propensity score matching was used to balance baseline characteristics between groups. The primary outcome was composite fracture, and secondary outcomes included hip fracture, vertebral fracture, and non‑hip non‑vertebral fracture. Cumulative incidence was estimated using the Kaplan-Meier method, and Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
RESULTS: A total of 434,627 postmenopausal women with osteoporosis were included, of whom 106,591 had T2DM and 328,036 did not. After propensity score matching, compared with the non-DM group, the DM group had significantly higher risks of composite fracture (HR = 1.30, 95% CI: 1.26-1.33), hip fracture (HR = 1.64, 95% CI: 1.52-1.77), vertebral fracture (HR = 1.18, 95% CI: 1.11-1.25), and non-hip non-vertebral fracture (HR = 1.34, 95% CI: 1.29-1.40).
CONCLUSIONS: Among postmenopausal women with osteoporosis, coexisting T2DM was associated with an increased risk of overall and site-specific fractures, particularly hip fracture. These findings suggest that fracture prevention in patients with osteoporosis should consider the additional risk associated with T2DM and follow-up care in this high-risk population.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
CO190
Topic
Clinical Outcomes, Epidemiology & Public Health, Real World Data & Information Systems
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)