Association between hyperglycaemia and fracture risk in non-diabetic middle-aged and older Australians: A national, population-based prospective study (AusDiab)

C. Gagnon, D. J. Magliano, P. R. Ebeling, D. W. Dunstan, P. Z. Zimmet, J. E. Shaw, R. M. Daly

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

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.

LanguageEnglish
Pages2067-2074
Number of pages8
JournalOsteoporosis International
Volume21
Issue number12
DOIs
Publication statusPublished - 1 Dec 2010

Keywords

  • Fractures
  • Glycemia
  • Insulin
  • Pre-diabetes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Gagnon, C. ; Magliano, D. J. ; Ebeling, P. R. ; Dunstan, D. W. ; Zimmet, P. Z. ; Shaw, J. E. ; Daly, R. M. / Association between hyperglycaemia and fracture risk in non-diabetic middle-aged and older Australians : A national, population-based prospective study (AusDiab). In: Osteoporosis International. 2010 ; Vol. 21, No. 12. pp. 2067-2074.
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title = "Association between hyperglycaemia and fracture risk in non-diabetic middle-aged and older Australians: A national, population-based prospective study (AusDiab)",
abstract = "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.",
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Association between hyperglycaemia and fracture risk in non-diabetic middle-aged and older Australians : A national, population-based prospective study (AusDiab). / Gagnon, C.; Magliano, D. J.; Ebeling, P. R.; Dunstan, D. W.; Zimmet, P. Z.; Shaw, J. E.; Daly, R. M.

In: Osteoporosis International, Vol. 21, No. 12, 01.12.2010, p. 2067-2074.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association between hyperglycaemia and fracture risk in non-diabetic middle-aged and older Australians

T2 - Osteoporosis International

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

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EP - 2074

JO - Osteoporosis International

JF - Osteoporosis International

SN - 0937-941X

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