Supplementary Materials for "Degree of Joint Risk Factor Control and Incident Fracture Outcomes in Individuals with Type 2 Diabetes"

Type 2 diabetes is closely associated with skeletal fragility, which increases the risk of fractures. Fracture prevention in individuals with type 2 diabetes is crucial for reducing fracture incidence. This study explores the relationship between joint risk factor control and fracture risk in individuals with type 2 diabetes. Six modifiable risk factors were assessed: body mass index (BMI), physical activity, smoking, alcohol consumption, serum 25-hydroxyvitamin D [25(OH)D], and glycated hemoglobin A_1c (HbA_1c). The findings demonstrated that controlling multiple risk factors significantly reduced fracture risk, with optimal control correlating with a 50% reduction in overall fractures and a 60% reduction in hip fractures. Furthermore, individuals with type 2 diabetes who controlled four or more risk factors experienced fracture risk comparable to that of non-diabetic controls. These results underscore the importance of joint risk factor management in mitigating the excess fracture risk associated with type 2 diabetes.

2型糖尿病（Type 2 diabetes）与骨骼脆性密切相关，可升高骨折发生风险。对2型糖尿病患者开展骨折预防工作，对于降低骨折发生率至关重要。本研究旨在探讨2型糖尿病患者的联合危险因素控制与骨折风险之间的关联。研究共评估了6项可干预的危险因素：体重指数（body mass index, BMI）、体力活动、吸烟、饮酒、血清25-羟维生素D [25(OH)D]以及糖化血红蛋白A_1c（glycated hemoglobin A_1c, HbA_1c）。研究结果表明，对多项危险因素进行综合控制可显著降低骨折风险，其中最优的危险因素控制策略可使总体骨折发生风险降低50%，髋部骨折风险降低60%。此外，控制了4项及以上危险因素的2型糖尿病患者，其骨折风险与非糖尿病对照人群相当。上述研究结果进一步凸显了联合危险因素管理对于缓解2型糖尿病相关超额骨折风险的重要意义。