TY - JOUR
T1 - Association between hyperglycaemia and fracture risk in non-diabetic middle-aged and older Australians
T2 - A national, population-based prospective study (AusDiab)
AU - Gagnon, C.
AU - Magliano, D. J.
AU - Ebeling, P. R.
AU - Dunstan, D. W.
AU - Zimmet, P. Z.
AU - Shaw, J. E.
AU - Daly, R. M.
PY - 2010/12/1
Y1 - 2010/12/1
N2 - The association between pre-diabetes and fracture risk remains unclear. In this large cohort of middle-aged and older Australian men and women without diabetes, elevated 2-h plasma glucose and pre-diabetes were associated with a reduced 5-year risk of low trauma and all fractures in women, independently of BMI, fasting insulin and other lifestyle factors. Introduction: We aimed to (1) examine associations between fasting and 2-h plasma glucose (FPG and 2-h PG), fasting insulin and risk of low trauma and all fractures in non-diabetic adults and (2) compare fracture risk between adults with pre-diabetes (impaired glucose tolerance or impaired fasting glucose) and those with normal glucose tolerance (NGT). Methods: Six thousand two hundred fifty-five non-diabetic men and women aged ≥40 years with NGT (n=4,855) and pre-diabetes (n=1,400) were followed for 5 years in the AusDiab Study. Fractures were self-reported. Results: Five hundred thirty-nine participants suffered at least one fracture (368 women, 171 men), of which the majority (318) occurred after a low-energy trauma (258 women, 60 men). In women, a 2-h PG ≥7.2 mmol/L (highest quartile) was associated with a decreased risk of low trauma and all fractures independent of age and BMI [OR (95% CI) for low trauma fractures, 0.59 (0.40-0.88)], but also fasting insulin, smoking, physical activity, history of fracture, dietary calcium and alcohol intake or menopausal status. There was no effect of 2-h PG on fracture risk in men [OR (95% CI), 1.39 (0.60-3.26)] or any relationship between fracture risk and quartiles of FPG or insulin in either sex. Compared to women with NGT, those with pre-diabetes had a reduced risk of fracture [OR (95% CI) for all fractures, 0.70 (0.52-0.95); for low trauma fractures, 0.75 (0.53-1.05)]. Conclusion: Elevated 2-h PG levels and pre-diabetes were inversely associated with low trauma and/or all fractures in non-diabetic women, independent of BMI and fasting insulin levels.
AB - The association between pre-diabetes and fracture risk remains unclear. In this large cohort of middle-aged and older Australian men and women without diabetes, elevated 2-h plasma glucose and pre-diabetes were associated with a reduced 5-year risk of low trauma and all fractures in women, independently of BMI, fasting insulin and other lifestyle factors. Introduction: We aimed to (1) examine associations between fasting and 2-h plasma glucose (FPG and 2-h PG), fasting insulin and risk of low trauma and all fractures in non-diabetic adults and (2) compare fracture risk between adults with pre-diabetes (impaired glucose tolerance or impaired fasting glucose) and those with normal glucose tolerance (NGT). Methods: Six thousand two hundred fifty-five non-diabetic men and women aged ≥40 years with NGT (n=4,855) and pre-diabetes (n=1,400) were followed for 5 years in the AusDiab Study. Fractures were self-reported. Results: Five hundred thirty-nine participants suffered at least one fracture (368 women, 171 men), of which the majority (318) occurred after a low-energy trauma (258 women, 60 men). In women, a 2-h PG ≥7.2 mmol/L (highest quartile) was associated with a decreased risk of low trauma and all fractures independent of age and BMI [OR (95% CI) for low trauma fractures, 0.59 (0.40-0.88)], but also fasting insulin, smoking, physical activity, history of fracture, dietary calcium and alcohol intake or menopausal status. There was no effect of 2-h PG on fracture risk in men [OR (95% CI), 1.39 (0.60-3.26)] or any relationship between fracture risk and quartiles of FPG or insulin in either sex. Compared to women with NGT, those with pre-diabetes had a reduced risk of fracture [OR (95% CI) for all fractures, 0.70 (0.52-0.95); for low trauma fractures, 0.75 (0.53-1.05)]. Conclusion: Elevated 2-h PG levels and pre-diabetes were inversely associated with low trauma and/or all fractures in non-diabetic women, independent of BMI and fasting insulin levels.
KW - Fractures
KW - Glycemia
KW - Insulin
KW - Pre-diabetes
UR - http://www.scopus.com/inward/record.url?scp=78549258091&partnerID=8YFLogxK
U2 - 10.1007/s00198-009-1164-y
DO - 10.1007/s00198-009-1164-y
M3 - Article
C2 - 20306023
AN - SCOPUS:78549258091
VL - 21
SP - 2067
EP - 2074
JO - Osteoporosis International
JF - Osteoporosis International
SN - 0937-941X
IS - 12
ER -