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The Association Between Hyperglycemia and Fracture Risk in Middle Age. A prospective, population-based study of 22 444 men and 10 902 women.

Holmberg, Anna H LU ; Nilsson, P M; Nilsson, Jan-Åke LU and Akesson, K (2008) In Journal of Clinical Endocrinology and Metabolism 93(3). p.815-822
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 (FBG) and high 2-hour glucose during an oral glucose tolerance test (OGTT) indicate impaired glucose tolerance or diabetes. The associations between FBG, 2-h glucose and the risk of fracture were investigated. Methods: The Malmö Preventive Project consists of 22 444 men (44 +/- 6.6 yrs) and 10 902 women (50 +/- 7.4 yrs), with a follow-up of 19 (+/-3.9)years and 15 (+/-4.5) years for incident fractures. Baseline assessment included multiple examinations and lifestyle information. A logistic regression model was used. Adjustments were made for age, BMI, and smoking.... (More)
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 (FBG) and high 2-hour glucose during an oral glucose tolerance test (OGTT) indicate impaired glucose tolerance or diabetes. The associations between FBG, 2-h glucose and the risk of fracture were investigated. Methods: The Malmö Preventive Project consists of 22 444 men (44 +/- 6.6 yrs) and 10 902 women (50 +/- 7.4 yrs), with a follow-up of 19 (+/-3.9)years and 15 (+/-4.5) years for incident fractures. Baseline assessment included multiple examinations and lifestyle information. A logistic regression model was used. Adjustments were made for age, 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/L in men (2(nd) and 3(rd) quartiles), and above 6.5 mmol/L in women (3(rd) and 4(th) quartiles), adjusted for age, BMI, and smoking, was significantly associated with decreased risk of multiple fractures, in men (ORs 0.57-0.71) and women (ORs 0.38-0.66). In women, a 2-h glucose measurement above 7.5 mmol/L was associated with a decreased risk of osteoporotic fractures (OR 0.57, CI 95% 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. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Clinical Endocrinology and Metabolism
volume
93
issue
3
pages
815 - 822
publisher
The Endocrine Society
external identifiers
  • pmid:18073298
  • wos:000253822700026
  • scopus:40849092547
ISSN
1945-7197
DOI
10.1210/jc.2007-0843
language
English
LU publication?
yes
id
b7179574-aa1f-48e2-af8a-4c8c886e6d50 (old id 1035365)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18073298?dopt=Abstract
date added to LUP
2008-04-01 15:44:49
date last changed
2017-01-01 06:23:51
@article{b7179574-aa1f-48e2-af8a-4c8c886e6d50,
  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 (FBG) and high 2-hour glucose during an oral glucose tolerance test (OGTT) indicate impaired glucose tolerance or diabetes. The associations between FBG, 2-h glucose and the risk of fracture were investigated. Methods: The Malmö Preventive Project consists of 22 444 men (44 +/- 6.6 yrs) and 10 902 women (50 +/- 7.4 yrs), with a follow-up of 19 (+/-3.9)years and 15 (+/-4.5) years for incident fractures. Baseline assessment included multiple examinations and lifestyle information. A logistic regression model was used. Adjustments were made for age, 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/L in men (2(nd) and 3(rd) quartiles), and above 6.5 mmol/L in women (3(rd) and 4(th) quartiles), adjusted for age, BMI, and smoking, was significantly associated with decreased risk of multiple fractures, in men (ORs 0.57-0.71) and women (ORs 0.38-0.66). In women, a 2-h glucose measurement above 7.5 mmol/L was associated with a decreased risk of osteoporotic fractures (OR 0.57, CI 95% 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.},
  author       = {Holmberg, Anna H and Nilsson, P M and Nilsson, Jan-Åke and Akesson, K},
  issn         = {1945-7197},
  language     = {eng},
  number       = {3},
  pages        = {815--822},
  publisher    = {The Endocrine Society},
  series       = {Journal of Clinical Endocrinology and Metabolism},
  title        = {The Association Between Hyperglycemia and Fracture Risk in Middle Age. A prospective, population-based study of 22 444 men and 10 902 women.},
  url          = {http://dx.doi.org/10.1210/jc.2007-0843},
  volume       = {93},
  year         = {2008},
}