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Nontraumatic Fracture Risk With Diabetes Mellitus and Impaired Fasting Glucose in Older White and Black Adults: The Health, Aging, and Body Composition Study
Abstract
BACKGROUND: Diabetes mellitus (DM) and related complications may increase clinical fracture risk in older adults. METHODS: Our objectives were to determine if type 2 diabetes mellitus or impaired fasting glucose was associated with higher fracture rates in older adults and to evaluate how diabetic individuals with fractures differed from those without fractures. The Health, Aging, and Body Composition Study participants were well-functioning, community-dwelling men and women aged 70 to 79 years (N = 2979; 42% black), of whom 19% had DM and 6% had impaired fasting glucose at baseline. Incident nontraumatic clinical fractures were verified by radiology reports for a mean +/- SD of 4.5 +/- 1.1 years. Cox proportional hazards regression models determined how DM and impaired fasting glucose affected subsequent risk of fracture. RESULTS: Diabetes mellitus was associated with elevated fracture risk (relative risk, 1.64; 95% confidence interval, 1.07-2.51) after adjustment for a hip bone mineral density (BMD) and fracture risk factors. Impaired fasting glucose was not significantly associated with fractures (relative risk, 1.34; 95% confidence interval, 0.67-2.67). Diabetic participants with fractures had lower hip BMD (0.818 g/cm(2) vs 0.967 g/cm(2); P<.001) and lean mass (44.3 kg vs 51.7 kg) and were more likely to have reduced peripheral sensation (35% vs 14%), transient ischemic attack/stroke (20% vs 8%), a lower physical performance battery score (5.0 vs 7.0), and falls (37% vs 21%) compared with diabetic participants without fractures (P<.05). CONCLUSIONS: These results indicate that older white and black adults with DM are at higher fracture risk compared with nondiabetic adults with a similar BMD since a higher risk of nontraumatic fractures was found after adjustment for hip BMD. Fracture prevention needs to target specific risk factors found in older adults with DM.
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Guralnik, J. M., Simonsick, E. M., Ferrucci, L., Glynn, R. J., Berkman, L. F., Blazer, D. G., Scherr, P. A., & Wallace, R. B. (1994) · Journal of Gerontology · doi:10.1093/geronj/49.2.m85 · Cited by 9,792
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Self-citationRosiglitazone-Associated Fractures in Type 2 Diabetes
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In Vivo Assessment of Bone Quality in Postmenopausal Women With Type 2 Diabetes
Farr, J. N., Drake, M. T., Amin, S., Melton, L. J., McCready, L. K., & Khosla, S. (2014) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.2106 · Cited by 499
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Utility of the trabecular bone score (TBS) in secondary osteoporosis
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Metadata
- Authors
- Strotmeyer, E. S., Cauley, J. A., Schwartz, A. V., Nevitt, M. C., Resnick, H. E., Bauer, D. C., Tylavsky, F. A., de Rekeneire, N., Harris, T. B., & Newman, A. B.
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2005-07-25
- Volume
- 165
- Issue
- 14
- Pages
- 1612
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2147642606
- Cited by
- 377
- References
- 1
- FWCI
- 17.88
- Type
- journal article
- Language
- en
- Open access
- closed
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- The paper
- Strotmeyer, E. S., Cauley, J. A., Schwartz, A. V., Nevitt, M. C., Resnick, H. E., Bauer, D. C., Tylavsky, F. A., de Rekeneire, N., Harris, T. B., & Newman, A. B. (2005). Nontraumatic Fracture Risk With Diabetes Mellitus and Impaired Fasting Glucose in Older White and Black Adults: The Health, Aging, and Body Composition Study. Archives of Internal Medicine. https://doi.org/10.1001/archinte.165.14.1612
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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
