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Diabetes duration related to fracture risk in women
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Women’s risk for fracture significantly increases with longer duration of diabetes, with high fracture risk associated with disease duration of more than 10 years, study data show.
Sumit R. Majumdar, MD, MPH, associate professor in the department of medicine, University of Alberta, Canada, and colleagues evaluated data from a clinical DXA registry linked to Manitoba administration databases on 8,840 women with type 2 diabetes and 49,048 women without diabetes. Participants underwent hip DXA measurements between 1996 and 2013. Over 7 years, incident major osteoporotic fracture and incident hip fractures were measured. The WHO fracture risk assessment tool (FRAX) was used to calculate the 10-year probability of major osteoporotic fracture and hip fracture.
Diabetes duration was more than 10 years in 31.4% of participants with the disease, 5 to 10 years in 20.1% and less than 5 years in 23.7%; 24.8% had new-onset diabetes.
Compared with participants without diabetes, participants with diabetes were more likely to experience incident major osteoporotic fracture (FRAX-adjusted HR = 1.19; 95% CI, 1.1-1.28; fully adjusted HR = 1.11; 95% CI, 1.03-1.21) and hip fracture (FRAX-adjusted HR = 1.66; 95% CI, 1.45-1.89; fully adjusted HR = 1.56; 95% CI, 1.36-1.79).
Diabetes duration for more than 10 years was independently related to incident fracture in the FRAX-adjusted analyses; this remained significant in the fully adjusted model (HR = 1.34; 95% CI, 1.17-1.54). Increased risk for hip fracture was associated with any duration of diabetes, and a duration of more than 10 years was associated with the greatest risk (FRAX-adjusted HR = 2.1; 95% CI, 1.71-2.59; fully adjusted HR = 1.94; 95% CI, 1.54-2.44).
“Confirming a diagnosis of type 2 diabetes significantly increases the risk of hip fracture, and once a woman has had type 2 diabetes for a decade (all else being equal) she has more than a 30% increased risk of [major osteoporotic fracture] and more than a 90% increased risk of hip fracture when compared to a woman without diabetes,” the researchers wrote. “These substantially elevated risks as they relate to duration of disease have not been captured using conventional fracture risk assessment tools such as FRAX.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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