Comparative risk of osteoporosis in older women with type 2 diabetes receiving sodium–glucose cotransporter 2 inhibitor or dipeptidyl peptidase-4 inhibitor: A nationwide cohort study

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes Pub Date : 2026-02-01 Epub Date: 2025-12-23 DOI:10.1016/j.pcd.2025.12.005

Hyeon Jeong Lee, Pusoon Chun

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引用次数: 0

Abstract

Aim

To compare osteoporosis risk associated with sodium–glucose cotransporter 2 inhibitor (SGLT2i) versus dipeptidyl peptidase-4 inhibitor (DPP-4i) in older women with type 2 diabetes (T2D).

Methods

This cohort study used the Korean National Health Insurance database. Adjusted hazard ratios (aHRs) were estimated using multivariable Cox regression. Sensitivity analysis was performed using inverse probability of treatment weighting (IPTW).

Results

Among 1715,337 women aged ≥ 55 years with T2D, 5364 SGLT2i users and 26,504 DPP-4i users were analyzed. The incidence rates of osteoporosis were 6.7 (95 % CI, 6.0–7.4) and 7.0 (95 % CI, 6.7–7.3) per 100 person-years in the SGLT2i and DPP-4i groups, respectively. Osteoporosis risk with SGLT2i was comparable to DPP-4i (aHR, 0.93; 95 % CI, 0.89–1.04). These results remained consistent in the sensitivity analysis using IPTW (aHR, 0.95; 95 % CI, 0.89–1.00). Subgroup analyses showed a slightly lower osteoporosis risk with SGLT2i in patients aged 55–64 years (aHR, 0.84; 95 % CI, 0.76–0.93), those without prior rheumatoid arthritis (aHR, 0.90; 95 % CI, 0.83–0.97), proton pump inhibitor use (aHR, 0.88; 95 % CI, 0.80–0.96), or oral corticosteroid use (aHRs, 0.91; 95 % CI, 0.85–0.97).

Conclusion

SGLT2i was comparable to DPP-4i in osteoporosis risk among older women with T2D.

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接受钠-葡萄糖共转运蛋白2抑制剂或二肽基肽酶-4抑制剂治疗的老年2型糖尿病女性骨质疏松的比较风险：一项全国性队列研究

目的：比较老年2型糖尿病（T2D）女性中钠-葡萄糖共转运蛋白2抑制剂（sglti）与二肽基肽酶4抑制剂（DPP-4i）的骨质疏松风险。方法：本队列研究使用韩国国民健康保险数据库。校正风险比（aHRs）采用多变量Cox回归估计。采用处理加权逆概率（IPTW）进行敏感性分析。结果：在1715名年龄≥ 55岁的T2D女性中，分析了5364名SGLT2i使用者和26,504名DPP-4i使用者。在SGLT2i组和DPP-4i组中，骨质疏松症的发病率分别为每100人年6.7（95 % CI, 6.0-7.4）和7.0（95 % CI, 6.7-7.3）。SGLT2i的骨质疏松风险与DPP-4i相当（aHR, 0.93; 95 % CI, 0.89-1.04）。这些结果在IPTW敏感性分析中保持一致（aHR, 0.95; 95 % CI, 0.89-1.00）。亚组分析显示，55-64岁（aHR, 0.84; 95 % CI, 0.76-0.93）、既往无类风湿关节炎（aHR, 0.90; 95 % CI, 0.83-0.97）、使用质子泵抑制剂（aHR, 0.88; 95 % CI, 0.80-0.96）或口服皮质类固醇（aHR, 0.91; 95 % CI, 0.85-0.97）的SGLT2i患者骨质疏松风险略低。结论：SGLT2i与DPP-4i在老年T2D女性骨质疏松风险方面具有可比性。

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来源期刊

Primary Care Diabetes ENDOCRINOLOGY & METABOLISM-PRIMARY HEALTH CARE

CiteScore

5.00

自引率

3.40%

发文量

134

审稿时长

47 days

期刊介绍： The journal publishes original research articles and high quality reviews in the fields of clinical care, diabetes education, nutrition, health services, psychosocial research and epidemiology and other areas as far as is relevant for diabetology in a primary-care setting. The purpose of the journal is to encourage interdisciplinary research and discussion between all those who are involved in primary diabetes care on an international level. The Journal also publishes news and articles concerning the policies and activities of Primary Care Diabetes Europe and reflects the society''s aim of improving the care for people with diabetes mellitus within the primary-care setting.