Impact of hip fracture on all‐cause mortality in Japanese patients with type 2 diabetes mellitus: The Fukuoka Diabetes Registry

Aims/Introduction Patients with type 2 diabetes mellitus have an increased hip fracture risk. We investigated the relationship between hip fracture and all‐cause death in patients with type 2 diabetes in comparison with cardiovascular disease ( CVD ) or end‐stage renal disease ( ERSD ). Materials and Methods In total, 4,923 Japanese participants with type 2 diabetes (mean age 65 years, 2,790 men, 2,133 women) were followed for a median of 5.3 years (follow‐up rate 99.5%). We evaluated the associations between the presence of hip fracture ( n  = 110), upper limb fracture ( n  = 801), CVD ( n  = 1,344), ESRD ( n  = 104) and all‐cause death by logistic regression analysis. Results A total of 309 participants died during follow up. Multivariate‐adjusted odds ratios ( OR s) for all‐cause mortality were significantly higher in participants with hip fractures than those without hip fractures ( OR 2.67, 95% confidence interval [ CI ] 1.54–4.41), whereas the OR s for upper limb fracture were not significant. The OR s for all‐cause mortality were significantly higher in participants with CVD than those without CVD ( OR 1.78, 95% CI , 1.39–2.70) and ESRD ( OR 2.36, 95% CI 1.32–4.05). The OR s for all‐cause mortality of hip fracture were not affected by further adjustment for CVD and ESRD ( OR 2.74, 95% CI 1.58–4.54). The cause of death was infection (40.0%), malignant neoplasm (25.0%) and CVD (15.0%) among participants with hip fracture. Conclusions Hip fractures were associated with an increased risk of death among Japanese patients with type 2 diabetes, independently of CVD and ESRD .