Risk Factors for Fracture in Patients with Coexisting Chronic Kidney Disease and Type 2 Diabetes: An Observational Analysis from the CREDENCE Trial
Table 1
Multivariable Cox-proportional model for the association between: (a) established traditional risk factors and fracture; (b) general population exploratory risk factors and fracture; (c) CKD-MBD factors and fracture; (d) diabetic osteodystrophy-related factors and fracture; e) cardiovascular risk factors and fracture.
Variable
1a) Traditional risk factors
1b) Exploratory risk factors
1c) CKD-MBD
1d) Diabetic osteodystrophy
1e) Cardiovascular risk factors
Hazard ratio
95% confidence interval
value
Hazard ratio
95% confidence interval
value
Hazard ratio
95% confidence interval
value
Hazard ratio
95% confidence interval
value
Hazard ratio
95% confidence interval
value
Sex (female)
2.32
1.65–3.25
<0.001
2.26
1.60–3.19
<0.001
2.35
1.63–3.38
<0.001
2.25
1.59–3.17
<0.001
2.45
1.73–3.48
<0.001
Age (years)
1.03
1.01–1.05
0.001
1.04
1.02–1.06
<0.001
1.03
1.01–1.06
0.001
1.04
1.02–1.06
0.001
1.03
1.01–1.05
0.009
History of fracture (Y)
2.29
1.59–3.29
<0.001
2.19
1.51–3.17
<0.001
2.25
1.56–3.24
<0.001
2.34
1.62–3.39
<0.001
2.25
1.56–3.24
<0.001
Asian race (ref. white)
1.72
1.13–2.62
0.012
Black (ref. white)
0.35
0.11–1.11
0.074
Other (ref. white)
1.19
0.66–2.15
0.571
Serum albumin (g/dL)
0.47
0.30–0.72
0.001
Thyroid hormone use (Y)
1.13
0.69–1.85
0.634
Proton pump inhibitor use (Y)
1.27
0.86–1.88
0.229
Calcium supplement use (Y)
1.06
0.46–2.46
0.897
Vitamin D therapy (Y)
1.96
1.27–3.03
0.002
Beta blocker use (Y)
0.95
0.66–1.35
0.764
Urine albumin to creatinine ratio (mg/g)
1.00
1.00–1.00
0.863
eGFR (mL/min/1.73 m2)
0.99
0.97–1.01
0.238
Magnesium (mg/dL)
0.67
0.34–1.30
0.234
Phosphate (mg/dL)
1.04
0.76–1.42
0.822
Calcium (mg/dL)
0.72
0.52–1.00
0.051
Bicarbonate (mEq/L)
1.01
0.95–1.07
0.767
Alkaline phosphatase (IU/L)
1.00
1.00–1.01
0.195
Sodium (mEQ/L)
1.02
0.97–1.09
0.434
Urate (mg/dL)
1.07
0.96–1.19
0.246
Diabetes duration (years)
0.99
0.97–1.01
0.437
BMI (kg/m2)
0.98
0.95–1.01
0.134
HbA1c (%)
1.12
0.98–1.27
0.095
Insulin use (Y)
1.22
0.81–1.82
0.34
Retinopathy (Y)
1.17
0.82–1.68
0.376
Neuropathy (y)
1.07
0.75–1.51
0.723
Statin use (Y)
1.33
0.87–2.04
0.182
Systolic blood pressure (mmHg)
1.00
0.99–1.01
0.91
Triglycerides (mmol/L)
1.00
0.89–1.11
0.956
LDL-C (mmol/L)
0.99
0.83–1.18
0.893
Smoking habit (Y)
0.93
0.54–1.61
0.799
History of cardiovascular disease (Y)
1.45
1.02–2.07
0.039
For the base-case model of traditional risk factors, no cases were excluded. For the overall multivariable model, 43 cases were omitted due to missing data. BMI: body mass index; CKD-MBD: chronic kidney disease-mineral bone disorder; eGFR: estimated glomerular filtration rate (note: estimated glomerular filtration was calculated using the CKD-EPI (CKD Epidemiology Collaboration) formula); LDL-C: low-density lipoprotein-cholesterol; SBP: systolic blood pressure; UACR: urine albumin-to-creatinine ratio.
