Potential Explanatory Factors for Higher Incident Hip Fracture Risk in Older Diabetic Adults

Overview

Journal Curr Gerontol Geriatr Res

Specialty Geriatrics

Date 2011 Aug 13

PMID 21837239

Citations 10

Authors

Elsa S Strotmeyer

Aruna Kamineni

Jane A Cauley

John A Robbins

Linda F Fried

David S Siscovick

Tamara B Harris

Anne B Newman

Affiliations

Soon will be listed here.

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.

Citing Articles

Differences in the roles of types 1 and 2 diabetes in the susceptibility to the risk of fracture: a systematic review and meta-analysis.

Dou J, Wang J, Zhang Q Diabetol Metab Syndr. 2021; 13(1):84.

PMID: 34399851 PMC: 8369647. DOI: 10.1186/s13098-021-00687-8.

Diabetes mellitus and the risk of fractures at specific sites: a meta-analysis.

Wang H, Ba Y, Xing Q, Du J BMJ Open. 2019; 9(1):e024067.

PMID: 30610024 PMC: 6326306. DOI: 10.1136/bmjopen-2018-024067.

The effects of dipeptidyl peptidase-4 inhibitors on bone fracture among patients with type 2 diabetes mellitus: A network meta-analysis of randomized controlled trials.

Yang J, Huang C, Wu S, Xu Y, Cai T, Chai S PLoS One. 2017; 12(12):e0187537.

PMID: 29206832 PMC: 5716604. DOI: 10.1371/journal.pone.0187537.

Diabetes, bone and glucose-lowering agents: clinical outcomes.

Schwartz A Diabetologia. 2017; 60(7):1170-1179.

PMID: 28451714 DOI: 10.1007/s00125-017-4283-6.

Diabetes mellitus and risk of hip fractures: a meta-analysis.

Fan Y, Wei F, Lang Y, Liu Y Osteoporos Int. 2015; 27(1):219-28.

PMID: 26264604 DOI: 10.1007/s00198-015-3279-7.

References

Janghorbani M, van Dam R, Willett W, Hu F . Systematic review of type 1 and type 2 diabetes mellitus and risk of fracture. Am J Epidemiol. 2007; 166(5):495-505. DOI: 10.1093/aje/kwm106. View

Ivers R, Cumming R, Mitchell P, Peduto A . Diabetes and risk of fracture: The Blue Mountains Eye Study. Diabetes Care. 2001; 24(7):1198-203. DOI: 10.2337/diacare.24.7.1198. View

Ottenbacher K, Ostir G, Peek M, Goodwin J, Markides K . Diabetes mellitus as a risk factor for hip fracture in mexican american older adults. J Gerontol A Biol Sci Med Sci. 2002; 57(10):M648-53. DOI: 10.1093/gerona/57.10.m648. View

Nicodemus K, Folsom A . Type 1 and type 2 diabetes and incident hip fractures in postmenopausal women. Diabetes Care. 2001; 24(7):1192-7. DOI: 10.2337/diacare.24.7.1192. View

Fried L, Biggs M, Shlipak M, Seliger S, Kestenbaum B, Stehman-Breen C . Association of kidney function with incident hip fracture in older adults. J Am Soc Nephrol. 2006; 18(1):282-6. DOI: 10.1681/ASN.2006050546. View

Schwartz A, Sellmeyer D, Strotmeyer E, Tylavsky F, Feingold K, Resnick H . Diabetes and bone loss at the hip in older black and white adults. J Bone Miner Res. 2005; 20(4):596-603. DOI: 10.1359/JBMR.041219. View

Hirsch A, Criqui M, Regensteiner J, Creager M, Olin J, Krook S . Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA. 2001; 286(11):1317-24. DOI: 10.1001/jama.286.11.1317. View

Fried L, Shlipak M, Stehman-Breen C, Mittalhenkle A, Seliger S, Sarnak M . Kidney function predicts the rate of bone loss in older individuals: the Cardiovascular Health Study. J Gerontol A Biol Sci Med Sci. 2006; 61(7):743-8. DOI: 10.1093/gerona/61.7.743. View

Bonds D, Larson J, Schwartz A, Strotmeyer E, Robbins J, Rodriguez B . Risk of fracture in women with type 2 diabetes: the Women's Health Initiative Observational Study. J Clin Endocrinol Metab. 2006; 91(9):3404-10. DOI: 10.1210/jc.2006-0614. View

10.

Psaty B, Lee M, Savage P, Rutan G, German P, Lyles M . Assessing the use of medications in the elderly: methods and initial experience in the Cardiovascular Health Study. The Cardiovascular Health Study Collaborative Research Group. J Clin Epidemiol. 1992; 45(6):683-92. DOI: 10.1016/0895-4356(92)90143-b. View

11.

Fried L, Borhani N, Enright P, Furberg C, Gardin J, Kronmal R . The Cardiovascular Health Study: design and rationale. Ann Epidemiol. 1991; 1(3):263-76. DOI: 10.1016/1047-2797(91)90005-w. View

12.

Janghorbani M, Feskanich D, Willett W, Hu F . Prospective study of diabetes and risk of hip fracture: the Nurses' Health Study. Diabetes Care. 2006; 29(7):1573-8. DOI: 10.2337/dc06-0440. View

13.

Wong S, Kwok T, Woo J, Lynn H, Griffith J, Leung J . Bone mineral density and the risk of peripheral arterial disease in men and women: results from Mr. and Ms Os, Hong Kong. Osteoporos Int. 2005; 16(12):1933-8. DOI: 10.1007/s00198-005-1968-3. View

14.

Levey A, Eckardt K, Tsukamoto Y, Levin A, Coresh J, Rossert J . Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2005; 67(6):2089-100. DOI: 10.1111/j.1523-1755.2005.00365.x. View

15.

Kiel D, Kauppila L, Cupples L, Hannan M, ODonnell C, Wilson P . Bone loss and the progression of abdominal aortic calcification over a 25 year period: the Framingham Heart Study. Calcif Tissue Int. 2001; 68(5):271-6. DOI: 10.1007/BF02390833. View

16.

Ahmed L, Joakimsen R, Berntsen G, Fonnebo V, Schirmer H . Diabetes mellitus and the risk of non-vertebral fractures: the Tromsø study. Osteoporos Int. 2005; 17(4):495-500. DOI: 10.1007/s00198-005-0013-x. View

17.

Kahn S, Haffner S, Heise M, Herman W, Holman R, Jones N . Glycemic durability of rosiglitazone, metformin, or glyburide monotherapy. N Engl J Med. 2006; 355(23):2427-43. DOI: 10.1056/NEJMoa066224. View

18.

Schwartz A, Sellmeyer D, Ensrud K, Cauley J, Tabor H, Schreiner P . Older women with diabetes have an increased risk of fracture: a prospective study. J Clin Endocrinol Metab. 2001; 86(1):32-8. DOI: 10.1210/jcem.86.1.7139. View

19.

Lipscombe L, Jamal S, Booth G, Hawker G . The risk of hip fractures in older individuals with diabetes: a population-based study. Diabetes Care. 2007; 30(4):835-41. DOI: 10.2337/dc06-1851. View

20.

Cushman M, Cornell E, Howard P, Bovill E, Tracy R . Laboratory methods and quality assurance in the Cardiovascular Health Study. Clin Chem. 1995; 41(2):264-70. View