J I-H Chiang1, T-C Li2,3, C-I Li4,5, C-S Liu4,5,6, N-H Meng4,7, W-Y Lin4,6, S-Y Yang2, H-J Chen8, C-C Lin9,10,11. 1. Department of General Practice, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia. 2. Graduate Institute of Biostatistics, College of Public Health, China Medical University, Taichung, Taiwan. 3. Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan. 4. School of Medicine, College of Medicine, China Medical University, 91 Hsueh-Shih Road, Taichung, 40421, Taiwan. 5. Department of Medical Research, China Medical University Hospital, Taichung, Taiwan. 6. Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan. 7. Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan. 8. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. 9. School of Medicine, College of Medicine, China Medical University, 91 Hsueh-Shih Road, Taichung, 40421, Taiwan. cclin@mail.cmuh.org.tw. 10. Department of Medical Research, China Medical University Hospital, Taichung, Taiwan. cclin@mail.cmuh.org.tw. 11. Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan. cclin@mail.cmuh.org.tw.
Abstract
We investigated the association between fasting plasma glucose variability (FPG-CV) and the risk of hip fracture in elderly diabetic patients. Our finding showed a temporal association between FPG-CV and hip fracture as patients categorized as FPG-CV greater than 25.4 % showed an increased risk in hip fractures. INTRODUCTION: Hip fracture is a major health burden in the population and is associated with high rates of mortality and morbidity especially in elderly. It is evident that diabetes mellitus is a risk factor of osteoporosis which is a significant risk factor of hip fracture. However, epidemiological studies exploring the risks of hip fracture among type 2 diabetic patients are limited. METHODS: A retrospective study of 26,501 ethnic Chinese older persons enrolled in the National Diabetes Care Management program in Taiwan was conducted; related factors were analyzed with extended Cox proportional hazards regression models to competing risk data on hip fracture incidence. RESULTS: The results show a temporal association between FPG-CV and hip fracture as patients categorized as FPG-CV greater than 25.4 % showed an increased risk in hip fractures, confirming a linear relationship between the two. After multivariate adjustment, the risk of hip fracture increased among patients with FPG-CV of 25.4-42.3 % and >42.3 % compared with patients with FPG-CV of ≦ 14.3 % (hazard ratio, 1.35; 95 % confidence interval 1.14-1.60 and 1.27; 1.07-1.52, respectively). Significant linear trends among various FPG-CV were observed. CONCLUSIONS: Thus, the present study demonstrated the importance of glucose stability for fracture prevention in older persons with type 2 diabetes. Future studies should be conducted to explore whether reduction in glucose oscillation in older adults with diabetes mellitus can reduce the risk of hip fracture.
We investigated the association between fasting plasma glucose variability (FPG-CV) and the risk of hip fracture in elderly diabeticpatients. Our finding showed a temporal association between FPG-CV and hip fracture as patients categorized as FPG-CV greater than 25.4 % showed an increased risk in hip fractures. INTRODUCTION:Hip fracture is a major health burden in the population and is associated with high rates of mortality and morbidity especially in elderly. It is evident that diabetes mellitus is a risk factor of osteoporosis which is a significant risk factor of hip fracture. However, epidemiological studies exploring the risks of hip fracture among type 2 diabeticpatients are limited. METHODS: A retrospective study of 26,501 ethnic Chinese older persons enrolled in the National Diabetes Care Management program in Taiwan was conducted; related factors were analyzed with extended Cox proportional hazards regression models to competing risk data on hip fracture incidence. RESULTS: The results show a temporal association between FPG-CV and hip fracture as patients categorized as FPG-CV greater than 25.4 % showed an increased risk in hip fractures, confirming a linear relationship between the two. After multivariate adjustment, the risk of hip fracture increased among patients with FPG-CV of 25.4-42.3 % and >42.3 % compared with patients with FPG-CV of ≦ 14.3 % (hazard ratio, 1.35; 95 % confidence interval 1.14-1.60 and 1.27; 1.07-1.52, respectively). Significant linear trends among various FPG-CV were observed. CONCLUSIONS: Thus, the present study demonstrated the importance of glucose stability for fracture prevention in older persons with type 2 diabetes. Future studies should be conducted to explore whether reduction in glucose oscillation in older adults with diabetes mellitus can reduce the risk of hip fracture.
Entities:
Keywords:
Fasting plasma glucose variability; Hip fracture; Type 2 diabetes