Potential explanatory factors for higher incident hip fracture risk in older diabetic adults
- PMID: 21837239
- PMCID: PMC3152969
- DOI: 10.1155/2011/979270
Potential explanatory factors for higher incident hip fracture risk in older diabetic adults
Abstract
Type 2 diabetes is associated with higher fracture risk. Diabetes-related conditions may account for this risk. Cardiovascular Health Study participants (N = 5641; 42.0% men; 15.5% black; 72.8±5.6 years) were followed 10.9 ± 4.6 years. Diabetes was defined as hypoglycemic medication use or fasting glucose (FG) ≥126 mg/dL. Peripheral artery disease (PAD) was defined as ankle-arm index <0.9. Incident hip fractures were from medical records. Crude hip fracture rates (/1000 person-years) were higher for diabetic vs. non-diabetic participants with BMI <25 (13.6, 95% CI: 8.9-20.2 versus 11.4, 95% CI: 10.1-12.9) and BMI ≥25 to <30 (8.3, 95% CI: 5.7-11.9 versus 6.6, 95% CI: 5.6-7.7), but similar for BMI ≥30. Adjusting for BMI, sex, race, and age, diabetes was related to fractures (HR = 1.34; 95% CI: 1.01-1.78). PAD (HR = 1.25 (95% CI: 0.92-1.57)) and longer walk time (HR = 1.07 (95% CI: 1.04-1.10)) modified the fracture risk in diabetes (HR = 1.17 (95% CI: 0.87-1.57)). Diabetes was associated with higher hip fracture risk after adjusting for BMI though this association was modified by diabetes-related conditions.
Figures
References
-
- Vestergaard P. Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes—a meta-analysis. Osteoporosis International. 2007;18(4):427–444. - PubMed
-
- Janghorbani M, Van Dam RM, Willett WC, Hu FB. Systematic review of type 1 and type 2 diabetes mellitus and risk of fracture. American Journal of Epidemiology. 2007;166(5):495–505. - PubMed
-
- Ahmed LA, Joakimsen RM, Berntsen GK, Fønnebø V, Schirmer H. Diabetes mellitus and the risk of non-vertebral fractures: the Tromso study. Osteoporosis International. 2006;17(5):495–500. - PubMed
-
- Janghorbani M, Feskanich D, Willett WC, Hu F. Prospective study of diabetes and risk of hip fracture: the nurses’ health study. Diabetes Care. 2006;29(7):1573–1578. - PubMed
-
- Holmberg AH, Johnell O, Nilsson PM, Nilsson J, Berglund G, Åkesson K. Risk factors for fragility fracture in middle age. A prospective population-based study of 33,000 men and women. Osteoporosis International. 2006;17(7):1065–1077. - PubMed
Grants and funding
- P30 AG024827/AG/NIA NIH HHS/United States
- R56 AG020098/AG/NIA NIH HHS/United States
- N01 HC055222/HL/NHLBI NIH HHS/United States
- N01 HC085079/HL/NHLBI NIH HHS/United States
- R01 HL080295/HL/NHLBI NIH HHS/United States
- R01 AG020098/AG/NIA NIH HHS/United States
- R01 AG015928/AG/NIA NIH HHS/United States
- U01 HL080295/HL/NHLBI NIH HHS/United States
- N01 HC015103/HC/NHLBI NIH HHS/United States
- N01 HC085086/HL/NHLBI NIH HHS/United States
- N01 HC075150/HL/NHLBI NIH HHS/United States
- R01 AG023629/AG/NIA NIH HHS/United States
- R01 AG027058/AG/NIA NIH HHS/United States
- N01 HC045133/HC/NHLBI NIH HHS/United States
- N01 HC035129/HC/NHLBI NIH HHS/United States
- R56 AG023629/AG/NIA NIH HHS/United States
