目的:先前的研究表明糖尿病对骨骼健康有代际影响。我们研究了父母糖尿病与后代严重骨质疏松性骨折(MOF)风险之间的关系。
方法:这项基于人群的队列研究使用了来自马尼托巴省的去识别的行政卫生数据,加拿大,记录人口水平的住院记录,医生访问和药物分配。该队列包括40岁以上的个体,在1997年至2015年的数据中确定了至少1名父母。自1970年以来,暴露于父母诊断为糖尿病;结果是后代MOF诊断为髋关节,前臂,脊柱或肱骨。两种措施均使用经过验证的病例定义从医院和医生就诊记录中确定。多变量Cox比例风险回归模型测试了父母糖尿病和后代MOF风险的关联。
结果:该队列包括279,085个后代;48.5%为女性,86.8%为≤44岁。在89.4%的队列中确定了父母双方;36.7%的父母诊断为糖尿病。在12.0的中位数随访期间(四分位数间距,6.0至18.0)年,8,762个后代有MOF诊断。调整骨折危险因素后,父母的糖尿病诊断与MOF风险无关,是否在父亲中诊断(调整后的危险比[AHR],1.02;95%置信区间[CI],0.97至1.08),母亲(AHR,1.02;95%CI,0.97至1.07)或父母双方(AHR,1.01;95%CI,0.93至1.11)。结果在按后代性别进行的分层分析中保持一致,基于MOF位点和敏感性分析的二次分析。
结论:结果表明父母糖尿病与后代MOF风险无关。
OBJECTIVE: Previous research suggests an intergenerational influence of diabetes on bone health. We examined the association between parental diabetes and major osteoporotic fracture (MOF) risk in offspring.
METHODS: This population-based cohort study used de-identified administrative health data from Manitoba, Canada, which capture population-level records of hospitalizations, physician visits and drug dispensations. The cohort included individuals 40+ years with at least 1 parent identified in the data between 1997 and 2015. The exposure was parental diagnosis of diabetes since 1970; the outcome was offspring incident MOF diagnosis of the hip, forearm, spine or humerus. Both measures were identified from hospital and physician visit records using validated case definitions. Multivariable Cox proportional hazards regression models tested the association of parental diabetes and offspring MOF risk.
RESULTS: The cohort included 279,085 offspring; 48.5% were females and 86.8% were ≤44 years of age. Both parents were identified for 89.4% of the cohort; 36.7% had a parental diabetes diagnosis. During a median follow up of 12.0 (interquartile range, 6.0 to 18.0) years, 8,762 offspring had a MOF diagnosis. After adjusting for fracture risk factors, parental diabetes diagnosis was not associated with MOF risk, whether diagnosed in fathers (adjusted hazard ratio [aHR], 1.02; 95% confidence interval [CI], 0.97 to 1.08), mothers (aHR, 1.02; 95% CI, 0.97 to 1.07) or both parents (aHR, 1.01; 95% CI, 0.93 to 1.11). The results remained consistent in a stratified analysis by offspring sex, secondary analysis based on MOF site and sensitivity analyses.
CONCLUSIONS: The results indicate parental diabetes is not associated with offspring MOF risk.