J Korean Med Sci.  2019 Sep;34(35):e224. 10.3346/jkms.2019.34.e224.

Effect of Dipeptidyl Peptidase-4 Inhibitors on the Risk of Bone Fractures in a Korean Population

• Ustulin M
• Park SY
• Choi H
• Chon S
• Woo JT
• Rhee SY

• KMID: 2456256
• DOI: http://doi.org/10.3346/jkms.2019.34.e224

Abstract

BACKGROUND
There have been equivocal results in studies of the effects of dipeptidyl peptidase-4 inhibitors (DPP-4i) on fractures. In this study, we analyzed the effect of DPP-4i on bone fracture risk in a Korean population.
METHODS
We extracted subjects (n = 11,164) aged 50 years or older from the National Health Insurance Service-National Sample Cohort 2.0 from 2009 to 2014. Our control group included subjects without diabetes (n = 5,582), and our treatment groups with diabetes included DPP-4i users (n = 1,410) and DPP-4i non-users (n = 4,172). The primary endpoint was the incidence of a composite outcome consisting of osteoporosis diagnosis, osteoporotic fractures, vertebral fractures, non-vertebral fractures, and femoral fractures. The secondary endpoint was the incidence of each individual component of the composite outcome. Survival analysis was performed with adjustment for age, gender, diabetes complications severity index, Charlson comorbidity index, hypertension medication, and dyslipidemia treatment.
RESULTS
The incidence of the composite outcome per 1,000 person-years was 0.089 in DPP-4i users, 0.099 in DPP-4i non-users, and 0.095 in controls. There was no significant difference in fracture risk between DPP-4i users and DPP-4i non-users or controls after the adjustments (P > 0.05). The incidences of osteoporosis diagnosis, osteoporotic fractures, vertebral fractures, non-vertebral fractures, and femoral fractures were not significantly different between DPP-4i users and non-users. The results of subgroup analyses by gender and age were consistent.
CONCLUSION
DPP-4i had no significant effect on the risk of fractures in a Korean population.

Keyword

Type 2 Diabetes Mellitus; Fractures; Osteoporosis; Dipeptidyl-Peptidase IV Inhibitors

MeSH Terms

Cohort Studies
Comorbidity
Diabetes Complications
Diabetes Mellitus, Type 2
Diagnosis
Dipeptidyl-Peptidase IV Inhibitors
Dyslipidemias
Femoral Fractures
Fractures, Bone*
Hypertension
Incidence
National Health Programs
Osteoporosis
Osteoporotic Fractures
Dipeptidyl-Peptidase IV Inhibitors