The diagnosis and prognosis of coronary microvascular disease using PET/CT

2021 ◽  
pp. 1-14
Author(s):  
Xi Zhang ◽  
Hui Li ◽  
Ping Wu ◽  
Lin Yuan ◽  
Zhifang Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Regression Model ◽  
Multiple Linear Regression Model ◽  
Microvascular Disease ◽  
Diabetic Patients ◽  
Diagnosis And Prognosis ◽  
Flow Reserve ◽  
Calcification Score ◽  
Pet Ct

OBJECTIVE: This study aimed to evaluate the diagnostic and prognostic value of 13N–NH3·H2O positron emission tomography combined with computed tomography (PET/CT) for non-obstructive coronary microvascular disease (CMVD). METHODS: A retrospective analysis was conducted on 70 patients with clinically suspected non-obstructive CMVD (35 males, 35 females) between March 2017 and August 2019. The average age of the patients was 53.32±7.82 years. The patients underwent 13N–NH3·H2O PET/CT and were divided into two groups based on diagnostic criteria: a CMVD group and a non-CMVD group. They were then followed up for 180–1,095 days. Data were analyzed using an χ 2 test, the logistic regression model, the multiple linear regression model, the Kaplan–Meier method, the Cox proportional hazards regression model, and a receiver operating characteristic (ROC) curve. RESULTS: (1) The incidence of cardiovascular family history and a high calcification score (11–400) was higher in the CMVD group than in the non-CMVD group (58.8% vs. 20.8% and 29.4% vs. 5.7%, respectively; P <  0.05 for all), stress myocardial blood flow (MBF) and coronary flow reserve (CFR) values were lower in the CMVD group than in the non-CMVD group (2.280±0.693 vs. 3.641±1.365 and 2.142±0.339 vs. 3.700±1.123, respectively), and calcification score was higher in the CMVD group than in the non-CMVD group (110.18±165.07 vs. 13.21±41.68, respectively; P <  0.05 for all). Gender and diabetes were risk factors for stress MBF reduction (β= 1.287 and β= –0.636, respectively), calcification score and hypertension were risk factors for CFR reduction (β= –0.004 and β= –0.654, respectively), and hypertension, family history, and calcification score were risk factors in the CMVD group (OR = 7.323, OR = 5.108, OR = 1.012, respectively; P <  0.05 for all). (2) The prognosis of patients with CFR <  2.5 was worse than that of patients with CFR≥2.5 (x 2 value: 27.404, P <  0.001). The risk of adverse cardiovascular events in diabetic patients was also increased (β= 0.328, P <  0.001). When CFR was set to 2.595, the prognostic sensitivity was 94% and the specificity was 80%. CONCLUSION: The technology of 13N–NH3·H2O PET/CT can be used for the diagnosis and prognosis of non-obstructive CMVD. Cardiovascular risk factors are related to the occurrence and prognosis of CMVD.

scholarly journals Comorbidities associated with reduced myocardial flow reserve in non-obstructive disease

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
H Gurrola-Luna ◽  
J K Rojas-Sernaque ◽  
A J Barajas Paulin ◽  
I Carvajal-Juarez ◽  
J L Bermudez-Gonzalez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Flow Reserve ◽  
Microvascular Angina ◽  
Cardiac Computed Tomography Angiography ◽  
Early Stages ◽  
Female Sex ◽  
Flow Reserve ◽  
Pet Ct ◽  
Myocardial Flow ◽  
Severe Ischemia

Abstract Introduction Microvascular Dysfunction defined as a Myocardial Flow Reserve (MFR) &lt;2 or &lt;2.5 depending on the center, may present in the absence of significant obstruction (1,2); it is included as a diagnosis criteria of Microvascular Angina (MVA) (3,4) and is an independent risk factor associated with poor prognosis (5–7). Traditional Coronary Artery Disease (CAD)risk factors have also been associated with MVA (8–10), however, there is reduced data in latin populations with high prevalence of comorbidities. The aim of this study was to identify the comorbidities that alter MFR with 13N-ammonia Positron Emission Tomography/Cardiac Tomography (PET/CT) and Cardiac Computed Tomography Angiography (CCTA) in a cardiovascular imaging referral center. Methods Retrospective cross-sectional study of patients with suspected CAD in which both PET/CT and CCTA were performed. Inclusion:CCTA with obstruction &lt;50%. Exclusion: incomplete study, previous infarction or intervention. Clinical data was assessed. Mean (±DE) or median (interquartile range) to present continuous variables according to their distribution; T student or U Man Whitney to compare them. For each variable two groups were conformed depending on its presence or absence in order to compare MFR between them. Statistical analysis was performed with Statistical Package for Social Science (SPSs Inc, Chicago, IL; version 23.0) and GraphPad Prism version 9.0. p&lt;0.05 was considered as significant. Results 335 patients included. MFR difference for each variable: female sex, hypertension (HT), Type 2 diabetes (T2D) and smoking – Appendix 1. Significant MFR difference for HT (p=0.024) and T2D (p=0.046). Severe ischemia had significant MFR reduction (p=0.006); patients with both HT and mild ischemia (p=0.018) – Appendix 2. Discussion Individuals with HT and T2D had a significantly lower MFR, consistent with previous studies (8,9). Absence of correlation with other risk factors, such as smoking (10) and female sex (11); latter may be caused by a significant lower number of women (108 vs 227). Further analysis in this subgroup ought to be done. When comparing MFR between level-of-ischemia groups, microvascular function was not reduced until severe ischemia. Remarkably, if we analyze the coexistence of HT with ischemia, MFR is reduced even in patients with mild ischemia. This finding highlights the importance of HT which alters function in early stages even in the absence of significant obstruction. This is one of the first studies correlating MFR with comorbidities in our population. Limitations the retrospective nature of the study. Conclusions MFR non-invasive assessment by PET/CT allows identifying very early stages of MVD, even in asymptomatic patients and when there's no evidence of ischemia or CAD. Therefore, timely recognition of this problem is mandatory to implement action strategies to stop the triggered events' cascade. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals The effects of obesity along with other risk factors on type 2 diabetic patients in the northwest of Libya

2020 ◽  
Vol 8 (2) ◽  
pp. 117-123
Author(s):  
Khaled Ali ALawaini ◽  
Mustafa Ali Abugila
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Family History ◽  
Positive Family History ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Face To Face ◽  
High Fasting Plasma Glucose ◽  
Type 2 Diabetic

Type 2 diabetes has several causes, such as family history, age, physical inactivity, and unhealthy food. Obesity is a significant cause of type 2 diabetes (T2D). Microvascular and macrovascular complications are associated with long-term diabetes. However, the main objective in this study is to search for complications and risk factors related to diabetes. Therefore, 472 diabetic patients with type 2 diabetes from northwest Libya participated in this study. Face-to-face interviews conducted using a questionnaire asking each patient information about name, age, sex, duration of disease, family history, and measured body mass index (BMI). A biochemical analysis (FPG, HbA1c, cholesterol, and triglyceride) was also performed on diabetic patients. Our results showed that 60.6% of type 2 diabetic patients had a positive family history. Poor glycemic control identified by high fasting plasma glucose (FPG) 186±9 mg/dl, and glycated hemoglobin was (HbA1C) 8.36%±1.8.

scholarly journals Differentiation of soft tissue and bone sarcomas from benign lesions utilizing 18F- FDG PET/CT-derived parameters

2020 ◽  
Author(s):  
Bo Chen ◽  
Hongbo Feng ◽  
Jinghui Xie ◽  
Chun Li ◽  
Yu Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Soft Tissue ◽  
Regression Model ◽  
Fdg Pet ◽  
Univariate Analysis ◽  
Ct Imaging ◽  
Bone Lesions ◽  
Benign Lesions ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background: Accurate differentiation between malignant and benign in soft tissue and bone lesions is essential for the prevention of excessive pathological biopsy and unplanned surgical resection. However, it remains a challenge and a standard diagnosis modality is urgently needed. The purpose of this study is to evaluate the usefulness of 18F- FDG PET/CT-derived parameters to differentiate soft tissue sarcoma (STS) and bone sarcoma (BS) from benign lesions.Methods: Patients who underwent pretreatment 18F-FDG PET/CT imaging and subsequent biopsy to confirm malignant (STS and BS, n=37) and benign (n=33) soft tissue and bone lesions were retrospectively reviewed. The tumor size, maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and heterogeneous factor (HF) of each lesion were measured. Univariate analysis and multivariate logistic regression analysis were performed to screen the significant risk factors to distinguish STS and BS from benign lesions. To establish a regression model based on independent risk factors, receiver operating characteristic (ROC) analysis was performed to assess the diagnostic performances.Results: Univariate analysis results showed that tumor size, SUVmax, MTV, TLG and HF of 18F-FDG PET/CT imaging in STS and BS group were all higher than benign lesions group, the difference were statistically significant (all P value were<0.01). However, the multivariate regression model only included SUVmax and HF as independent risk factors, odds radios were 1.135(95%CI: 1.026~1.256, P =0.014), 7.869(95%CI: 2.119~29.230, P =0.002), respectively. The regression model was as follow: Logit (P) = -2.461+0.127SUVmax+2.063HF. The area under the ROC was 0.860 (95%CI: 0.771~0.948, P <0.001) higher than SUVmax 0.744(95%CI: 0.628~0.860, P <0.001) and HF 0.790 (95%CI:0.684~0.896, P <0.001).Conclusion: The regression model including SUVmax and HF based on 18F-FDG PET/CT imaging may be useful for differentiating STS and BS from benign lesions.

scholarly journals Diagnostic and Prognostic Values of BMPER in Patients with Urosepsis following Ureteroscopic Lithotripsy

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Chang Geng Xu ◽  
Yong Lian Guo
Keyword(s):  
Risk Factors ◽  
Regression Model ◽  
Adverse Outcome ◽  
Strong Predictor ◽  
Multiple Linear Regression Model ◽  
Roc Curves ◽  
Rank Test ◽  
Ureteroscopic Lithotripsy ◽  
Pressure Groups ◽  
Reactive Protein

The present study aims to investigate the risk factors for urosepsis and the diagnostic and prognostic values of the bone morphogenetic protein endothelial cell precursor-derived regulator (BMPER) in patients with urosepsis following ureteroscopic lithotripsy. A total of 305 patients with unilateral ureteral obstruction caused by calculi were included in the study. Patients were divided into three groups, namely, high, medium, and low perfusion pressure groups. The serum C-reactive protein, procalcitonin, lactate (LAC), and BMPER were measured after operation. A logistic regression model was used to assess the risk factors for postoperative urosepsis. The relationships of BMPER with laboratory parameters were explored with a multiple linear regression model. Receiver operating characteristic (ROC) curves were used to diagnosis urosepsis. The cumulative incidence of the adverse events after operation was calculated and compared by log-rank test. Forty-five patients (14.8%) had an episode of urosepsis after operation. Irrigation pressure was an independent risk factor for urosepsis. LAC and sequential organ failure assessment (SOFA) were associated with BMPER after operation. The area under curve value of BMPER for urosepsis was 0.829 (95% confidence interval [CI], 0.773 to 0.884). Uroseptic patients with higher BMPER concentration exhibited more adverse outcome. BMPER possesses valuable discriminative capacity for urosepsis and is a strong predictor of adverse outcome in patients with urosepsis.

scholarly journals The E23K variant in the Kir6.2 subunit of the ATP-sensitive K+ channel does not augment impaired glucose tolerance in Caribbean subjects with a family history of type 2 diabetes

2005 ◽  
Vol 185 (3) ◽  
pp. 439-444 ◽  
Author(s):  
Chidum Ezenwaka ◽  
Risha Kalloo ◽  
Mathias Uhlig ◽  
Robert Schwenk ◽  
Juergen Eckel
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Family History ◽  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Diabetic Patients ◽  
Family History Of Diabetes ◽  
Control Subjects ◽  
History Of

The E23K variant of the Kir6.2 gene has been shown to be associated with type 2 diabetes mellitus in Caucasian subjects. Because offspring of type 2 diabetic patients have a genetically increased risk of developing diabetes, we sought to identify the E23K variant of the Kir6.2 gene in offspring of Caribbean patients with type 2 diabetes and assess the contribution of this variant to impaired glucose tolerance in these subjects. Forty-six offspring of patients with type 2 diabetes and 39 apparently healthy subjects whose immediate parents were not diabetic (‘control’) were studied after an overnight fast. Anthropometric indices were measured and blood samples were collected. Fasting and 2 h plasma glucose, insulin and lipids were subsequently determined. Insulin resistance was calculated using the homeostatic model assessment technique. The offspring and control subjects had similar frequencies of the E23K polymorphism (52.6 vs 45.5%, P>0.05) and the frequency of the E23K variant did not differ significantly between gender and ethnic distributions, irrespectively of a family history of diabetes (P>0.05). There were no significant differences in biochemical risk factors for developing diabetes in offspring carriers of the E23K variant compared with offspring non-carriers of the mutation. Offspring with the E23K mutation had even significantly higher 2 h insulin concentrations when compared with control subjects. It is concluded that the presence of the Kir6.2 E23K genotype in Caribbean subjects with an immediate positive family history of diabetes does not confer significantly higher levels of biochemical risk factors for the development of type 2 diabetes.

scholarly journals Prevalence and Risk Factors Associated with Type 2 Diabetes in Elderly Patients Aged 45-80 Years at Kanungu District

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Debrah Asiimwe ◽  
Godfrey O. Mauti ◽  
Ritah Kiconco
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Family History ◽  
Elderly Patients ◽  
Health Centre ◽  
Health Concern ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Factors Associated

Background. Type 2 diabetes is a worldwide disaster including in Uganda, specifically in Kanungu District which had a rise in diabetic patients in 2018/2019 as compared to the 2017/2018 financial year. This research was determined to access the prevalence and risk factors associated with type 2 diabetes on elderly patients aged 45-80 years attending Kanungu Health Centre IV, Kanungu District. Methods. A cross-sectional study was conducted among patients aged 45-80 years attending Kanungu Health Centre IV from June to August 2019. The prevalence of type 2 diabetes was determined by the blood sugar of patients. Questionnaires were used to collect data for factors associated with type 2 diabetes. Data were statistically analyzed using the statistical package for social sciences (SPSS) version 25 (SPSS Inc., USA) at P<0.05. Results. The overall prevalence of type 2 diabetes was 18.7% among the tested patients. 22.8% of diabetic patients were females as 7.8% were males. The age group most affected by diabetes was 61-65 years. Alcoholism, smoking, body mass index (BMI), and family history were found to be significantly associated with type 2 diabetes at P value < 0.05. Conclusion. There was a high prevalence of type 2 diabetes observed in this study compared to studies done in previous years which raise a public health concern. This study also found that females and patients aged 61-65 years were most affected by diabetes. Lastly, the presence of family history for diabetes, overweight, and being obese increases the chances of acquiring type 2 diabetes.

scholarly journals Risk Factors of Hypertension among Type 2 Diabetic Patients in Imo state, South East of Nigeria

2020 ◽  
pp. 65-72
Author(s):  
Ugonma, Winnie Dozie ◽  
Nnenna, Vivian Okonkwo ◽  
Okwuchi, Blessed Nworuh ◽  
Somtochukwu, Mercy Orji ◽  
Chidozie Joakin Nwaokoro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Family History ◽  
Dietary Pattern ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
History Of ◽  
Family History Of Hypertension ◽  
Type 2 Diabetic

Background: Hypertension is among the important causes of non-communicable disease burden worldwide. It has raised public health concerns in both developed and developing nations. It mostly occurs in patients with diabetes and the prevalence depends on duration, type and age of the patient. The study aimed at determining the risk factors of hypertension among type 2 diabetic patients in Imo State, Nigeria. Methods: A hospital-based descriptive survey design involving 50 patients attending hospital was used. Structured questionnaire complemented with interview schedule was used to collect data from the respondents. Data were analyzed using frequency and mean score. Hypotheses were tested using Chi-square at 5% significance level. Results: The result showed that the majority (70.0%) of the patients was hypertensive, 54.0% of the patients used dietary control and drugs in the treatment of the diseases. Furthermore, it was found that 54.0% ate salty foods always, 58.0% of the patients added extra table salt in their meals, 54.0% ate canned foods and 82.0% took sugary drinks always. It was also found that 66.0% ate always from restaurants and 58.0% ate more of starchy foods. The result further showed that 74.0% of the patients avoided physical exercise and 70.0% indicated that doing stress works made them get anxious. Eighty percent of the patients had hypertension in their family history and the 74.0% indicated it was their brother/sister. The X2 result showed a significantly association between family history of hypertension and type 2 diabetes X2(121, N = 50) = 187, p = 0.000. It was also found that dietary pattern was significantly associated with risk of type 2 diabetes X2(121, N = 50) = 187, p = 0.000. Conclusion: Dietary pattern and family history of hypertension were significantly associated with type 2 diabetes. It was recommended that sensitization campaigns be organized to educate women on the effect of diets on diabetes. Also, family history of hypertension should be ascertained from patients to ensure early detection and treatment of diabetes.

scholarly journals Characteristics of Objective Sleep and Its Related Risk Factors Among Parkinson's Disease Patients With and Without Restless Legs Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Shuyu Sun ◽  
Xianchao Zhao ◽  
Jiafeng Ren ◽  
Jinxiang Cheng ◽  
Junying Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Linear Regression ◽  
Sleep Quality ◽  
Regression Model ◽  
Multiple Linear Regression ◽  
Restless Legs Syndrome ◽  
Linear Regression Model ◽  
Multiple Linear Regression Model ◽  
Restless Legs ◽  
Related Risk

Objective: This study aimed to investigate the objective sleep characteristics and their related risk factors among Parkinson's disease (PD) patients with and without restless legs syndrome (RLS).Methods: A total of 125 patients with PD who underwent overnight polysomnography (PSG) were recruited consecutively. Eighty-one patients, including 27 PD with RLS (PD-RLS) and 54 PD without RLS (PD-NRLS), were included in the final analysis after 1:2 propensity score matching. Demographic, clinical, and polysomnographic data were compared between PD patients with and without RLS. The risk factors for sleep quality were examined using a multiple linear regression model.Results: The prevalence of RLS among PD patients was 28.0% (35/125). The PD-RLS group exhibited a higher score for the Unified Parkinson Disease Rating Scale (UPDRS) III than the PD-NRLS group. Also, the PD-RLS patients displayed significantly shorter total sleep times, worse sleep quality, decreased stage 3 duration, a longer wake time after sleep onset, and a higher arousal index than those without RLS (all p &lt; 0.05). In the multiple linear regression model, PD duration (β = −0.363, 95% CI: −0.652 to −0.074; p = 0.016), UPDRS-III (β = −0.356, 95% CI: −0.641 to −0.071; p = 0.016), and periodic limb movement index (PLMI) (β = −0.472, 95% CI: −0.757 to −0.187; p = 0.002) were determined to be the risk factors influencing sleep quality in PD-RLS patients. The UPDRS-III (β = −0.347, 95% CI: −0.590 to −0.104; p = 0.006) and HAMD scores (β = −0.343, 95% CI: −0.586 to −0.100; p = 0.007) were significantly associated with sleep quality after adjusting for confounding factors in PD-NRLS patients, respectively.Conclusions: PD-RLS patients exhibited more disturbed and fragmented sleep in objective sleep architecture than PD-NRLS patients. The severity of motor symptoms in PD was significantly associated with poor sleep quality in both PD-RLS and PD-NRLS patients. Notably, our findings indicated that periodic limb movements during sleep (PLMS) was the risk factor that influenced the objective sleep quality in PD patients with RLS.

scholarly journals Survival Outcome with Routine Clinical Use of 82Rb PET/CT Myocardial Blood Flow (MBF) Quantification

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
S Wan ◽  
ME Speechly-Dick ◽  
LJ Menezes ◽  
R Endozo ◽  
R Bell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Blood Flow ◽  
Ejection Fraction ◽  
Myocardial Blood Flow ◽  
Univariate Analysis ◽  
Myocardial Flow Reserve ◽  
Flow Reserve ◽  
Pet Ct ◽  
Myocardial Flow

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): NIHR Biomedical Research Centre, University College London Hospitals Background The prognostic value of 82Rb PET/CT derived myocardial blood flow (MBF) is increasingly recognised in both general and specific cardiovascular populations. Purpose This study investigates the prognostic potential of MBF in a large cohort of patients undergoing routine 82Rb PET/CT examination. Methods 1148 consecutive patients (687 males, mean age 64 +/- 12 years) whom had been referred for 82Rb PET/CT examination in a single centre were included in this study.  All patients completed a stress 82Rb PET/CT with adenosine infusion, paired with a rest study.  Dynamic PET acquisitions were performed in both. Cardiovascular risk factors were documented as per clinical routine. Images were checked for quality and analysed using a proprietary software by an experienced operator to derive MBF parameters.  Overall survival was recorded following the study. Results Median follow-up period was 71 +/- 28 months.  Mean survival was 121 (95% CI: 118-124) months. On univariate analysis, global myocardial flow reserve &lt;1.77 was associated with a higher all-cause mortality (p &lt; 0.001). Other parameters including higher age (&gt; =76 years), lower BMI (&lt;21), qualitative abnormality on the myocardial perfusion scan (MPS), low hyperaemic ejection fraction on the gated studies (stress &lt; 37 and rest &lt; 34). Patients being on cardiac glycosides and diuretics were also significant predictor of poor prognosis (p &lt; 0.001) on univariate analysis, presumably reflecting underlying arrhythmia and heart failure. A multivariate Cox regression analysis (step-wise Forward Wald), comprising of the above significant univariate markers, highlighted global myocardial flow reserve (HR: 2.6, 95%CI: 1.8-3.6, p &lt; 0.001), age (HR: 2.8, 95%CI: 2.0-3.9, p &lt; 0.001),, BMI (HR: 2.7, 95%CI: 1.7-4.1, p &lt; 0.001),, ejection fraction (stress - HR: 3.3, 95%CI: 2.3-4.8, p &lt; 0.001), MPS (HR: 1.5, 95%CI: 1.1-2.1, p = 0.024), and patients on diuretics (HR: 1.8, 95%CI: 1.2-2.5, p = 0.003) were independent predictors of overall survival (overall model: p &lt; 0.001) Discussion We show that high volume routinely derived MBF in patients undergoing 82Rb PET/CT is a strong predictor of mortality and independent of other risk factors. This has important clinical implication for measuring not only interventional treatment but also measuring the effect of lifestyle and medical strategies.

scholarly journals Risk Factors for Fracture in Diabetes: The Canadian Multicentre Osteoporosis Study

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Lisa-Ann Fraser ◽  
Alexandra Papaioannou ◽  
Jonathan D. Adachi ◽  
Jinhui Ma ◽  
Lehana Thabane
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Family History ◽  
Female Gender ◽  
Diabetic Patients ◽  
Mineral Density ◽  
Cross Sectional ◽  
Increased Risk ◽  
Traumatic Fracture ◽  
History Of

Objective. Individuals with diabetes have been found to be at increased risk of nontraumatic fracture. However, within the diabetic population, how to distinguish who is at the highest risk and warranting therapy has remained elusive. Design. Cross-sectional analysis of a national population-based cohort study. Patients. Men and women over the age of 50 with diabetes from across Canada. Measurements. Logistic regression analysis to identify diabetes specific factors associated with a history of one or more non-traumatic fractures. Results. Six hundred and six individuals with diabetes with a mean age of 69 years were examined. Thirty percent had a history of non-traumatic fracture. Macrovascular diseases in the form of stroke or TIA, as well as hypertension, were found to be independently associated with fragility fracture. Other, more traditional, clinical risk factors were also associated with fracture, including increased age, female gender, rheumatoid arthritis, family history of osteoporosis, and decreased bone mineral density. Conclusions. In this cohort of Canadians with diabetes, those with rheumatoid arthritis, a family history of osteoporosis, female gender, increased age, decreased BMD, cerebrovascular disease, or hypertension were more likely to have had a non-traumatic fracture. These risk factors may be important to clinicians when identifying which of their diabetic patients are at highest risk of fracture and in need of preventative therapies.

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