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

• 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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Ortopedi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Orthopaedics (hsv//eng)

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