Association between hyperglycaemia and fracture risk in non-diabetic middle-aged and older Australians : a national, population-based prospective study (AusDiab)

Gagnon, C., Magliano, D. J., Ebeling, P. R., Dunstan, D. W., Zimmet, P. Z., Shaw, J. E. and Daly, R. M. 2010, Association between hyperglycaemia and fracture risk in non-diabetic middle-aged and older Australians : a national, population-based prospective study (AusDiab), Osteoporosis international, vol. 21, no. 12, pp. 2067-2074.

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Title Association between hyperglycaemia and fracture risk in non-diabetic middle-aged and older Australians : a national, population-based prospective study (AusDiab)
Author(s) Gagnon, C.
Magliano, D. J.
Ebeling, P. R.
Dunstan, D. W.
Zimmet, P. Z.
Shaw, J. E.
Daly, R. M.
Journal name Osteoporosis international
Volume number 21
Issue number 12
Start page 2067
End page 2074
Publisher Springer International
Place of publication London, England
Publication date 2010
ISSN 0937-941X
1433-2965
Keyword(s) fractures
glycemia
insulin
pre-diabetes
Summary Summary : The association between pre-diabetes and fracture risk remains unclear. In this large cohort of middle-aged and older Australian men and women without diabetes, elevated 2-h plasma glucose and pre-diabetes were associated with a reduced 5-year risk of low trauma and all fractures in women, independently of BMI, fasting insulin and other lifestyle factors.

Introduction :
We aimed to (1) examine associations between fasting and 2-h plasma glucose (FPG and 2-h PG), fasting insulin and risk of low trauma and all fractures in non-diabetic adults and (2) compare fracture risk between adults with pre-diabetes (impaired glucose tolerance or impaired fasting glucose) and those with normal glucose tolerance (NGT).

Methods :
Six thousand two hundred fifty-five non-diabetic men and women aged ≥40 years with NGT (n = 4,855) and pre-diabetes (n = 1,400) were followed for 5 years in the AusDiab Study. Fractures were self-reported.

Results :
Five hundred thirty-nine participants suffered at least one fracture (368 women, 171 men), of which the majority (318) occurred after a low-energy trauma (258 women, 60 men). In women, a 2-h PG ≥7.2 mmol/L (highest quartile) was associated with a decreased risk of low trauma and all fractures independent of age and BMI [OR (95% CI) for low trauma fractures, 0.59 (0.40–0.88)], but also fasting insulin, smoking, physical activity, history of fracture, dietary calcium and alcohol intake or menopausal status. There was no effect of 2-h PG on fracture risk in men [OR (95% CI), 1.39 (0.60–3.26)] or any relationship between fracture risk and quartiles of FPG or insulin in either sex. Compared to women with NGT, those with pre-diabetes had a reduced risk of fracture [OR (95% CI) for all fractures, 0.70 (0.52–0.95); for low trauma fractures, 0.75 (0.53–1.05)].

Conclusion :
Elevated 2-h PG levels and pre-diabetes were inversely associated with low trauma and/or all fractures in non-diabetic women, independent of BMI and fasting insulin levels.
Language eng
Field of Research 110699 Human Movement and Sports Science not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2010, International Osteoporosis Foundation and National Osteoporosis Foundation
Persistent URL http://hdl.handle.net/10536/DRO/DU:30035178

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