{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T11:58:30Z","timestamp":1793879910518,"version":"4.7.0"},"reference-count":49,"publisher":"BMJ","license":[{"start":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T00:00:00Z","timestamp":1681776000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ"],"accepted":{"date-parts":[[2023,3,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the effect of denosumab compared with oral bisphosphonates on reducing the risk of type 2 diabetes in adults with osteoporosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Population based study involving emulation of a randomized target trial using electronic health records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>IQVIA Medical Research Data primary care database in the United Kingdom, 1995-2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adults aged 45 years or older who used denosumab or an oral bisphosphonate for osteoporosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>The primary outcome was incident type 2 diabetes, as defined by diagnostic codes. Cox proportional hazards models were used to estimate adjusted hazard ratios and 95% confidence intervals, comparing denosumab with oral bisphosphonates using an as treated approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>4301 new users of denosumab were matched on propensity score to 21\u2009038 users of an oral bisphosphonate and followed for a mean of 2.2 years. The incidence rate of type 2 diabetes in denosumab users was 5.7 (95% confidence interval 4.3 to 7.3) per 1000 person years and in oral bisphosphonate users was 8.3 (7.4 to 9.2) per 1000 person years. Initiation of denosumab was associated with a reduced risk of type 2 diabetes (hazard ratio 0.68, 95% confidence interval 0.52 to 0.89). Participants with prediabetes appeared to benefit more from denosumab compared with an oral bisphosphonate (hazard ratio 0.54, 0.35 to 0.82), as did those with a body mass index \u226530 (0.65, 0.40 to 1.06).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this population based study, denosumab use was associated with a lower risk of incident type 2 diabetes compared with oral bisphosphonate use in adults with osteoporosis. This study provides evidence at a population level that denosumab may have added benefits for glucose metabolism compared with oral bisphosphonates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmj-2022-073435","type":"journal-article","created":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T07:16:10Z","timestamp":1681802170000},"page":"e073435","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":61,"title":["Denosumab and incidence of type 2 diabetes among adults with osteoporosis: population based cohort study"],"prefix":"10.1136","volume":"381","author":[{"given":"Houchen","family":"Lyu","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, The Chinese PLA General Hospital, Beijing 100853, China"},{"name":"Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha 410008, China"},{"name":"National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, The Chinese PLA General Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sizheng Steven","family":"Zhao","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology Versus Arthritis, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Licheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The Chinese PLA General Hospital, Beijing 100853, China"},{"name":"National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, The Chinese PLA General Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of epidemiology and health statistics, Xiangya School of Public Health, Central South University, Changsha, China"},{"name":"Health Management Center, Xiangya Hospital, Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxiao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha 410008, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha 410008, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengbin","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The Chinese PLA General Hospital, Beijing 100853, China"},{"name":"National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, The Chinese PLA General Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vibeke","family":"Norvang","sequence":"additional","affiliation":[{"name":"Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Inflammation, and Immunity, Brigham and Women\u2019s Hospital, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara K","family":"Tedeschi","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Inflammation, and Immunity, Brigham and Women\u2019s Hospital, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha 410008, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China"},{"name":"Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2987-138X","authenticated-orcid":false,"given":"Guanghua","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha 410008, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China"},{"name":"Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4279-1704","authenticated-orcid":false,"given":"Peifu","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The Chinese PLA General Hospital, Beijing 100853, China"},{"name":"National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, The Chinese PLA General Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8202-5428","authenticated-orcid":false,"given":"Daniel H","family":"Solomon","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Inflammation, and Immunity, Brigham and Women\u2019s Hospital, Boston, MA 02115, USA"},{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,4,18]]},"reference":[{"key":"2025110102130774000_381.apr18_7.e073435.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0809493"},{"key":"2025110102130774000_381.apr18_7.e073435.2","doi-asserted-by":"publisher","DOI":"10.1038\/nrd3705"},{"key":"2025110102130774000_381.apr18_7.e073435.3","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2019-00221"},{"key":"2025110102130774000_381.apr18_7.e073435.4","doi-asserted-by":"publisher","DOI":"10.1007\/s11657-022-01061-5"},{"key":"2025110102130774000_381.apr18_7.e073435.5","doi-asserted-by":"publisher","DOI":"10.1002\/art.40137"},{"key":"2025110102130774000_381.apr18_7.e073435.6","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.53.7.1782"},{"key":"2025110102130774000_381.apr18_7.e073435.7","doi-asserted-by":"publisher","DOI":"10.1038\/nm.3084"},{"key":"2025110102130774000_381.apr18_7.e073435.8","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2991"},{"key":"2025110102130774000_381.apr18_7.e073435.9","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-019-14003-6"},{"key":"2025110102130774000_381.apr18_7.e073435.10","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.1865"},{"key":"2025110102130774000_381.apr18_7.e073435.11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2113319"},{"key":"2025110102130774000_381.apr18_7.e073435.12","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1335"},{"key":"2025110102130774000_381.apr18_7.e073435.13","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-51455-6_4"},{"key":"2025110102130774000_381.apr18_7.e073435.14","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-eular.4618"},{"key":"2025110102130774000_381.apr18_7.e073435.15","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwv254"},{"key":"2025110102130774000_381.apr18_7.e073435.16","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4107"},{"key":"2025110102130774000_381.apr18_7.e073435.17","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k2693"},{"key":"2025110102130774000_381.apr18_7.e073435.18","doi-asserted-by":"publisher","DOI":"10.7326\/M20-0289"},{"key":"2025110102130774000_381.apr18_7.e073435.19","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-0267"},{"key":"2025110102130774000_381.apr18_7.e073435.20","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14082"},{"key":"2025110102130774000_381.apr18_7.e073435.21","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j5019"},{"key":"2025110102130774000_381.apr18_7.e073435.22","doi-asserted-by":"publisher","DOI":"10.1002\/pst.433"},{"key":"2025110102130774000_381.apr18_7.e073435.23","doi-asserted-by":"publisher","DOI":"10.7326\/M20-0882"},{"key":"2025110102130774000_381.apr18_7.e073435.24","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-1616"},{"key":"2025110102130774000_381.apr18_7.e073435.25","doi-asserted-by":"publisher","DOI":"10.2337\/dc22-S002"},{"key":"2025110102130774000_381.apr18_7.e073435.26","doi-asserted-by":"publisher","DOI":"10.1002\/art.39537"},{"key":"2025110102130774000_381.apr18_7.e073435.27","doi-asserted-by":"publisher","DOI":"10.1002\/sim.8502"},{"key":"2025110102130774000_381.apr18_7.e073435.28","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2015.30"},{"key":"2025110102130774000_381.apr18_7.e073435.29","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/asn055"},{"key":"2025110102130774000_381.apr18_7.e073435.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2020.03.004"},{"key":"2025110102130774000_381.apr18_7.e073435.31","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-020-00707-3"},{"key":"2025110102130774000_381.apr18_7.e073435.32","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2607"},{"key":"2025110102130774000_381.apr18_7.e073435.33","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-S008"},{"key":"2025110102130774000_381.apr18_7.e073435.34","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000018067"},{"key":"2025110102130774000_381.apr18_7.e073435.35","doi-asserted-by":"publisher","DOI":"10.1172\/JCI125915"},{"key":"2025110102130774000_381.apr18_7.e073435.36","doi-asserted-by":"publisher","DOI":"10.1007\/s00223-015-0075-5"},{"key":"2025110102130774000_381.apr18_7.e073435.37","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/352858"},{"key":"2025110102130774000_381.apr18_7.e073435.38","doi-asserted-by":"publisher","DOI":"10.1038\/nm1166"},{"key":"2025110102130774000_381.apr18_7.e073435.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2015.05.021"},{"key":"2025110102130774000_381.apr18_7.e073435.40","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-020-0355-7"},{"key":"2025110102130774000_381.apr18_7.e073435.41","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0123279"},{"key":"2025110102130774000_381.apr18_7.e073435.42","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-3481"},{"key":"2025110102130774000_381.apr18_7.e073435.43","doi-asserted-by":"publisher","DOI":"10.1007\/s00223-011-9515-z"},{"key":"2025110102130774000_381.apr18_7.e073435.44","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.826997"},{"key":"2025110102130774000_381.apr18_7.e073435.45","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-022-06616-3"},{"key":"2025110102130774000_381.apr18_7.e073435.46","doi-asserted-by":"publisher","DOI":"10.1038\/s41413-021-00142-4"},{"key":"2025110102130774000_381.apr18_7.e073435.47","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2020.154264"},{"key":"2025110102130774000_381.apr18_7.e073435.48","doi-asserted-by":"publisher","DOI":"10.4065\/83.9.1032"},{"key":"2025110102130774000_381.apr18_7.e073435.49","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-1807"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj-2022-073435","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj-2022-073435","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T09:13:13Z","timestamp":1761988393000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj-2022-073435"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,18]]},"references-count":49,"alternative-id":["10.1136\/bmj-2022-073435"],"URL":"https:\/\/doi.org\/10.1136\/bmj-2022-073435","relation":{},"ISSN":["1756-1833"],"issn-type":[{"value":"1756-1833","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,18]]}}}