Fracture risk is increased by the complication of hypertension and treatment with calcium channel blockers in postmenopausal women with type 2 diabetes

Abstract

Patients with type 2 diabetes mellitus (T2DM) frequently have other common diseases such as hypertension (HT), dyslipidemia (DL), and cardiovascular disease (CVD). However, it is unknown whether or not the complication of these diseases would affect fracture risk in T2DM patients. We evaluated prevalent morphometric vertebral fractures (VFs) and prior non-VFs in 155 and 195 Japanese T2DM postmenopausal women, respectively, and examined their association with HT, DL, or CVD. VF, non-VF, HT, DL, and CVD were found in 53 (34 %), 30 (15 %), 136 (70 %), 124 (64 %), and 45 (23 %) women, respectively. Multivariate logistic regression analyses adjusted for age, body mass index (BMI), and serum creatinine showed that the presence of HT significantly increased VF risk [odds ratio (OR) 4.05, P = 0.0047], but not non-VF risk. This result was still significant after an additional adjustment for each of blood pressure levels, treatments with anti-hypertensive medications, and a history of falls. In contrast, calcium channel blocker (CCB) treatment significantly increased VF and non-VF risks after adjustments for age, BMI, serum creatinine, and blood pressure levels (OR 2.33, P = 0.0320 and OR 2.95, P = 0.0150, respectively), while these significances disappeared after an additional adjustment for a history of falls. These findings suggest that the presence of HT increases VF risk independent of blood pressure levels, anti-hypertensive medications, or falls, and that CCB treatment increases both VF and non-VF risks possibly via falls in T2DM postmenopausal women.