Examination of diabetes as a risk factor for osteoporosis among older adults in Korea: A population-based cohort study
Date
2023-11-02
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
ORCID
0009-0005-6669-5831
Type
Thesis
Degree Level
Masters
Abstract
With population aging worldwide, the prevalence of diabetes has significantly risen, leading to various complications. Recent evidence suggests there could be potential associations between diabetes as osteoporosis risk. This thesis aimed to examine whether diabetes represents an independent risk factor for osteoporosis onset in Korean adults aged 50 years and older.
The analysis utilized longitudinal data from the Korean National Health Panel Survey from 2008-2018, following 7304 participants aged 50+ years at baseline. Among them, a total of, 1616 individuals with diabetes and 5688 without diabetes were followed for up to 11 years to identify new clinically diagnosed osteoporotic events, including osteoporosis or osteoporotic fractures, based on Korean Standard Disease Classification codes. Kaplan-Meier curves displayed visual comparison of survival over time between diabetes groups and other different risk factors for osteoporosis events, and Cox proportional hazards models calculated adjusted hazard ratios (HRs) of different risk factors.
Over the study period, 794 new osteoporotic events were documented. Diabetes status did not significantly impact osteoporosis risk in multivariate analysis. Older age (70+ years) (vs. 50-60 years) (HR=10.32, 95% CI: 3.25–32.80) and female sex (vs. male) (HR=9.05, 95% CI: 5.32–15.40) emerged as key factors independently associated with greater osteoporosis hazards. Unexpectedly, people with hypertension (vs no hypertension) and previous smokers (vs non-smokers) had lower osteoporosis risk. There was a significant interaction of sex and age, with 60–70-year-old females having higher risk than their male counterparts.
In summary, while diabetes itself was not implicated as an independent predictor, this thesis identified critical demographic and clinical factors for osteoporosis onset in Korean adults aged 50+ years. These findings can guide screening initiatives and future research on underlying mechanisms.
Description
Keywords
- Osteoporosis
- Diabetes
- Bone density
- Fragility fractures
- Survival analysis
- Cox proportional hazards model
- Hazard ratio
- Risk factors
- Age
- Sex
- Hyperlipidemia
- Hypertension
- Smoking
- Korea
- Asian population
- Retrospective cohort
- Population-based study
- Time-to-event analysis
- Kaplan-Meier analysis
- Epidemiology
- Public health
- Chronic disease
- Comorbidity
Citation
Degree
Master of Science (M.Sc.)
Department
Medicine
Program
Health Sciences