Fracture risk in women with dysglycaemia — ASN Events
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Fracture risk in women with dysglycaemia (#76)

Lelia L F de Abreu 1 , Kara Holloway 1 , Mohammadreza Mohebbi 1 , Muhammad Sajjad 1 , Mark Kotowicz 1 2 , Julie Pasco 1 2
  1. Deakin University/Barwon Health, Geelong, VICTORIA, Australia
  2. Departament of Medicine, The University of Melbourne, Melbourne, Victoria, Australia

Aims Women with diabetes have a higher fracture risk and sustain fractures at higher BMD (bone mineral density). However, fracture risk in impaired fasting glucose (IFG), has not been thoroughly explored. This longitudinal study aimed to determine any associations between dysglycaemia and fractures in Australian women.

Methods This study included 564 women, aged 50+ years, enrolled in the Geelong Osteoporosis Study. Women were followed (median 13.7 years, IQR 7.4-14.8) from their baseline appointment (1993-1997), to date of first fracture, death or December 31, 2010, whichever occurred first. Fractures were identified from radiological reports. Hazard ratios (HRs) for all-fractures (all sites except fingers, toes and skull/face), as well as major osteoporotic fractures (MOF, clinical spine, hip, proximal humerus and wrist), in diabetes (n=66), IFG (n=247) and normoglycaemia (n=251), defined by IDF criteria, were calculated using a Cox proportional hazards model.

Results During follow-up, 162 women sustained any fracture and 104 had a MOF. Unadjusted fracture risk was higher in diabetes (HR=1.64;95%CI 1.02-2.63), but IFG and normoglycaemia had similar risk (HR 1.06;95%CI 0.76-1.47). Age- and BMD-adjusted all-fracture risk in diabetes compared to normoglycaemia was greater (HR 1.59;95%CI 0.98-2.58); IFG was similar to the normoglycaemia (HR 1.01;95%CI 0.72-1.41).

MOF results were similar; unadjusted and age- and BMD-adjusted fracture risk in IFG was similar to normoglycaemia HR 1.02;95%CI 0.74-1.40 and HR 0.95;95%CI 0.69-1.32, respectively, but diabetes was higher compared to normoglycaemia (unadjusted HR 1.64;95%CI 1.04-2.60; adjusted HR 1.57;95%CI 0.98-2.51).

Further adjustment for other variables (lean/fat mass, mobility and hypertension) did not affect the reported associations.

Conclusions Women with diabetes had increased fracture risk, all and MOF sites. However, there was no increase in fracture risk in IFG. Public health strategies for preventing the progression from IFG to diabetes may be effective to prevent fractures.