Association of sodium-glucose cotransporter 2 inhibitor use with risk of osteoporotic fracture among older women: A nationwide, population-based cohort study

Seunghyun Lee, Min Heui Yu, Namki Hong, Kyoung Jin Kim, Hae Kyung Kim, Yumie Rhee, Minyoung Lee, Kyoung Min Kim

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: We investigated the relationship between sodium-glucose cotransporter-2 inhibitor (SGLT2i) and fracture in elderly women diagnosed with type 2 diabetes mellitus (T2DM) and newly prescribed antidiabetic medications (ADMs). Material and methods: We used the population-based cohort study data from the National Health Insurance Service of Korea (2013–2020). Women ≥65 years old with T2DM, who were newly prescribed ADMs other than glucagon-like peptide-1 receptor agonists and thiazolidinedione, and who had comprehensive health check-up data were included. Results: A total of 1,333 SGLT2i users were matched in a 1:2 ratio with 2,626 non-SGLT2i users. After propensity score matching, mean age, body mass index, number of ADMs, and other covariates were well-balanced between SGLT2i users and non-SGLT2i users. During the follow-up period, a higher incidence of vertebral fractures in SGLT2i users than in non-SGLT2i users (incidence rate 19.2 vs. 13.8 per 1,000 person-years; hazard ratio 1.40, 95 % confidence interval 1.00–1.96, p = 0.049). No significant difference was noted in other types of fracture. Conclusion: SGLT2i use showed an increased risk of vertebral fracture than non-SGLT2i use in elderly women. Although further validation is required, SGLT2i should be cautiously prescribed in older women due to the potential association with fracture risk.

Original languageEnglish
Article number111712
JournalDiabetes Research and Clinical Practice
Volume213
DOIs
Publication statusPublished - 2024 Jul

Bibliographical note

Publisher Copyright:
© 2024

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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