The Association between Hyperglycemia and Fracture Risk in Middle Age. A Prospective, Population-Based Study of 22,444 Men and 10,902 Women (original) (raw)
Journal Article
1Lund University, Department of Clinical Sciences, Clinical and Molecular Osteoporosis Research Unit (A.H.H., J-A.N., K.A.), Malmö University Hospital, S-205 02 Malmö, Sweden
*Address all correspondence and requests for reprints to: Anna H. Holmberg, M.D., Ph.D., Department of Orthopaedics, Malmö University Hospital, S-205 02 Malmö, Sweden.
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2Departments of Medicine (P.M.N.), Malmö University Hospital, S-205 02 Malmö, Sweden
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1Lund University, Department of Clinical Sciences, Clinical and Molecular Osteoporosis Research Unit (A.H.H., J-A.N., K.A.), Malmö University Hospital, S-205 02 Malmö, Sweden
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1Lund University, Department of Clinical Sciences, Clinical and Molecular Osteoporosis Research Unit (A.H.H., J-A.N., K.A.), Malmö University Hospital, S-205 02 Malmö, Sweden
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Accepted:
29 November 2007
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A. H. Holmberg, P. M. Nilsson, J-Å. Nilsson, K. Åkesson, The Association between Hyperglycemia and Fracture Risk in Middle Age. A Prospective, Population-Based Study of 22,444 Men and 10,902 Women, The Journal of Clinical Endocrinology & Metabolism, Volume 93, Issue 3, 1 March 2008, Pages 815–822, https://doi.org/10.1210/jc.2007-0843
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Abstract
Aims: Type 1 diabetes mellitus is associated with increased fracture risk, whereas the risk associated with type 2 diabetes is less obvious. Elevated fasting blood glucose and high 2-h glucose during an oral glucose tolerance test indicate impaired glucose tolerance or diabetes. The associations among fasting blood glucose, 2-h glucose, and the risk of fracture were investigated.
Methods: The Malmö Preventive Project consists of 22,444 men (44 ± 6.6 yr) and 10,902 women (50 ±7.4 yr), with a follow-up of 19 yr (±3.9) and 15 yr (±4.5) for incident fractures. Baseline assessment included multiple examinations and lifestyle information. A logistic regression model was used. Adjustments were made for age, body mass index (BMI), and smoking.
Results: Low-energy fractures were recorded in 1246 men and 1236 women. A 2-h glucose measurement between 4.3 and 6.2 mmol/liter in men (second and third quartile), and above 6.5 mmol/liter in women (third and fourth quartile), adjusted for age, BMI, and smoking, was significantly associated with a decreased risk of multiple fractures, in men [odds ratios (ORs) 0.57–0.71] and women (ORs 0.38–0.66). In women, a 2-h glucose measurement above 7.5 mmol/liter was associated with a decreased risk of osteoporotic fractures (OR 0.57, 95% confidence interval 0.44–0.74).
Conclusions: In middle-aged men and women, elevated 2-h glucose levels were associated with decreased risks of multiple and osteoporotic fractures, independent of age, BMI, and smoking. A high 2-h glucose level is characterized by peripheral insulin resistance with a high insulin level. Our findings indirectly suggest a positive effect on bone from hyperglycemia.
Copyright © 2008 by The Endocrine Society
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