Pancreatic fat infiltration is associated with risk of vertebral fracture in older patients with type 2 diabetes: A longitudinal multicenter study

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes research and clinical practice Pub Date : 2024-10-22 DOI:10.1016/j.diabres.2024.111904

Jiangchuan Wang , Zicheng Wei , Yu Wang , Dingzhe Zhang , Miaomiao Wang , Xin Chen , Peng Xia , Jianhua Wang , Chao Xie , Xiao Chen

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Abstract

Aims

Patients with type 2 diabetes mellitus (T2DM) have high fracture risk. This study explored the associations between pancreatic computed tomography (CT) attenuation, a marker of pancreatic fat, and risk of vertebral fracture in T2DM patients.

Methods

A total of 1486 T2DM patients who aged 50 years and older and without preexisting vertebral fractures during 2019–2023 at our institutions were followed up until January 2024. CT attenuation of the pancreas, bone and spleen were measured. Pancreatic attenuation/spleen attenuation ratio (P/S) was calculated. Vertebral fractures were evaluated on spine CT images according to Genant’s semiquantitative scoring system.

Results

A total of 135 cases of vertebral fracture were identified during 26 months of follow-up and 270 patients without vertebral fracture were matched. Pancreatic CT attenuation and the P/S ratio were negatively associated with the risk of vertebral fracture (adjusted hazard ratio (aHR) = 0.97, 95 %confidence interval (CI): 0.96–0.99; aHR = 0.26, 95 %CI: 0.12–0.58). Addition of pancreatic attenuation or P/S ratio improved the performance of bone attenuation-based model (area under the curve = 0.72–0.763 vs 0.63–0.728).

Conclusion

Pancreatic fat infiltration is an associated factor for vertebral fracture in T2DM patients. Addition of pancreatic fat infiltration improved the predictive performance of the bone-based model.

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胰腺脂肪浸润与老年 2 型糖尿病患者椎体骨折的风险有关：一项纵向多中心研究

目的：2型糖尿病（T2DM）患者的骨折风险很高。本研究探讨了胰腺计算机断层扫描（CT）衰减（胰腺脂肪的标志物）与 T2DM 患者椎体骨折风险之间的关联：方法：对本院2019-2023年期间年龄在50岁及以上且无椎体骨折的1486名T2DM患者进行随访，直至2024年1月。测量了胰腺、骨骼和脾脏的 CT 衰减。计算胰腺衰减/脾脏衰减比（P/S）。根据 Genant 半定量评分系统对脊柱 CT 图像上的椎体骨折进行评估：结果：在26个月的随访中，共发现135例椎体骨折病例，并与270例未发生椎体骨折的患者进行了配对。胰腺 CT 衰减和 P/S 比值与椎体骨折风险呈负相关（调整后危险比 (aHR) = 0.97，95% 置信区间 (CI)：0.96-0.99；aHR = 0.26，95%CI：0.12-0.58）。加入胰腺衰减或 P/S 比值可提高基于骨衰减模型的性能（曲线下面积 = 0.72-0.763 vs 0.63-0.728）：结论：胰腺脂肪浸润是T2DM患者椎体骨折的相关因素。结论：胰腺脂肪浸润是 T2DM 患者椎体骨折的相关因素，加入胰腺脂肪浸润可提高基于骨的模型的预测性能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.