Journal
DIABETES CARE
Volume 36, Issue 6, Pages 1619-1628Publisher
AMER DIABETES ASSOC
DOI: 10.2337/dc12-1188
Keywords
-
Categories
Funding
- Erasmus Medical Center
- Erasmus University (Rotterdam, the Netherlands)
- Netherlands Organization for Health Research and Development
- Research Institute for Diseases in the Elderly
- Ministry of Education, Culture, and Science
- Ministry of Health, Welfare, and Sports
- European Commission (DG XII)
- Netherlands Genomics Initiative
- Netherlands Consortium of Healthy Ageing [050-060-810]
- Municipality of Rotterdam
- FP7-GEFOS Project
- European Commission [HEALTH-F2-2008-201865]
- Erasmus University Rotterdam
- Netherlands Organization for Scientific Research (VICI) [918-76-619]
Ask authors/readers for more resources
OBJECTIVE-Individuals with type 2 diabetes have increased fracture risk despite higher bone mineral density (BMD). Our aim was to examine the influence of glucose control on skeletal complications. RESEARCH DESIGN AND METHODS-Data of 4,135 participants of the Rotterdam Study, a prospective population-based cohort, were available (mean follow-up 12.2 years). At baseline, 420 participants with type 2 diabetes were classified by glucose control (according to HbA(1c) calculated from fructosamine), resulting in three comparison groups: adequately controlled diabetes (ACD; n = 203; HbA(1c) <7.5%), inadequately controlled diabetes (ICD; n = 217; HbA(1c) >= 7.5%), and no diabetes (n = 3,715). Models adjusted for sex, age, height, and weight (and femoral neck BMD) were used to test for differences in bone parameters and fracture risk (hazard ratio [FIR] [95% CI]). RESULTS-The ICD group had 1.1-5.6% higher BMD, 4.6-5.6% thicker cortices, and -1.2 to -1.8% narrower femoral necks than ACD and ND, respectively. Participants with ICD had 47-62% higher fracture risk than individuals without diabetes (HR 1.47 [1.12-1.92]) and ACD (1.62 [1.09-2.40]), whereas those with ACD had a risk similar to those without diabetes (0.91 [0.67-1.23]). CONCLUSIONS-Poor glycemic control in type 2 diabetes is associated with fracture risk, high BMD, and thicker femoral cortices in narrower bones. We postulate that fragility in apparently strong bones in ICD can result from microcrack accumulation and/or cortical porosity, reflecting impaired bone repair.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available