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

doi:10.1007/s00198-009-1164-y

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

Aboriginal Health Equity

Research output: Contribution to journal › Article

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.

Language	English
Pages	2067-2074
Number of pages	8
Journal	Osteoporosis International
Volume	21
Issue number	12
DOIs	10.1007/s00198-009-1164-y
Publication status	Published - 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. (2010). Association between hyperglycaemia and fracture risk in non-diabetic middle-aged and older Australians: A national, population-based prospective study (AusDiab). Osteoporosis International, 21(12), 2067-2074. https://doi.org/10.1007/s00198-009-1164-y

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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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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Gagnon, C, Magliano, DJ, Ebeling, PR, Dunstan, DW, Zimmet, PZ, Shaw, JE & Daly, RM 2010, 'Association between hyperglycaemia and fracture risk in non-diabetic middle-aged and older Australians: A national, population-based prospective study (AusDiab)', Osteoporosis International, vol. 21, no. 12, pp. 2067-2074. https://doi.org/10.1007/s00198-009-1164-y

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 journal › Article

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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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JO - Osteoporosis International