Hyperglycemia tied to higher fracture risk in elderly Japanese men

By Reuters Staff

NEW YORK (Reuters Health) - 17/1/2019

Community-dwelling elderly men with hyperglycemia are at elevated risk of osteoporotic fracture, according to Japanese researchers.

In a paper online January 4 in Bone, Dr. Masayuki Iki of Kindai University Faculty of Medicine, in Osaka, and colleagues observe that patients with type 2 diabetes mellitus are at increased fracture risk but studies are few and there have been none in Japanese men.

The researchers enrolled almost 2,000 men 65 years or older and followed them for five years. After excluding those with a history of type 1 diabetes and thiazolidinedione therapy, the team analyzed data on 1,951 men. Of these, 200 had type 2 diabetes diagnosed at baseline.

Osteoporotic fracture was defined as a radiographically confirmed fracture at any skeletal site other than the head, finger, lower thigh and foot that occurred without strong external force.

Compared to those who were normoglycemic, those with hyperglycemia in the diabetic range (HbA1c at or beyond 6.5%) were at significantly higher osteoporotic-fracture risk, with a hazard ratio of 2.76 after adjusting for confounders such as insulin use.

An elevated risk of osteoporotic fracture of the spine, hip, proximal humerus, or distal radius was also seen in the pre-diabetic category participants with HbA1c at or above 5.7% but less than 6.5% (HR, 2.15; P=0.05).

The relationship between higher glycemic levels and fractures appeared to be linear and remained significant even after excluding participants on anti-diabetic therapy. This result, say the researchers, "is not consistent with some previous studies that reported a J-shaped association between these variables."

"In the present study," the team concludes, "higher glycemic status was associated with increased fracture risk, whereas a diagnosis of type 2 diabetes mellitus was not."

Dr. Iki did not respond to requests for comments.

SOURCE: https://bit.ly/2APJ08K Bone 2019.

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