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A simple fragility fracture risk score for type 2 diabetes patients: a derivation, validation, comparison, and risk stratification study. | LitMetric

AI Article Synopsis

  • - The study aimed to create and validate two simple scoring systems to assess the risk of any fragility and major osteoporotic fractures in patients with type 2 diabetes, comparing their effectiveness to the existing FRAX tool.
  • - It involved 1,855 T2D patients and used a 5-year follow-up period, identifying cases of fragility fractures and major osteoporotic fractures while employing advanced statistical methods for analysis.
  • - Results showed that the new scores performed better in distinguishing fracture risk among T2D patients compared to FRAX, indicating the need for further validation in other patient groups.

Article Abstract

Objectives: The aims of this study were to develop and validate 2 simple scores for stratification of the risks of (1) any fragility (AF) and (2) major osteoporotic fracture (MOF) in type 2 diabetes (T2D) patients; we also compared the performance of these scores with that of the Fracture Risk Assessment Tool (FRAX) and its adjustments.

Design And Methods: In this longitudinal cohort study, 1855 patients with T2D were enrolled from January 2015 to August 2019. Cox proportional hazard regression was used to model the 5-year risk of AF and MOF. These scores were internally validated using a bootstrap resampling method of 1000.

Results: During a median follow-up of 5 years, 119 (6.42%) cases of AF and 92 (4.96%) cases of MOFs were identified. Both the concordance index (C-index) and calibration plots indicated improved identification performance using the newly established scores. Furthermore, these scores also showed improved outcomes regarding the decision curve analysis (DCA) and area under the curve (AUC) compared to the widely used FRAX and its derivatives. More importantly, these scores successfully separated T2D patients into risk groups according to significant differences in fracture incidence.

Conclusions: These novel scores enable simple and reliable fracture risk stratification in T2D patients. Future work is needed to validate these findings in external cohort(s).

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Source
http://dx.doi.org/10.1093/ejendo/lvad150DOI Listing

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