Fracture risk in diabetic elderly men

The MrOS study

Nicola Napoli, Elsa S. Strotmeyer, Kristine E. Ensrud, Deborah E. Sellmeyer, Douglas C. Bauer, Andrew R. Hoffman, Thuy Tien L Dam, Elizabeth Barrett-Connor, Lisa Palermo, Eric Orwoll, Steven R. Cummings, Dennis M. Black, Ann V. Schwartz

Research output: Contribution to journalArticle

101 Citations (Scopus)

Abstract

Aims/hypothesis Diabetes mellitus is associated with increased fracture risk in women but few studies are available in men. To evaluate the relationship between diabetes and prospective non-vertebral fractures in elderly men, we used data from the Osteoporotic Fractures in Men (MrOS) study. Methods The MrOS enrolled 5,994 men (aged ≥65 years). Diabetes (ascertained by self-report, the use of medication for diabetes or an elevated fasting glucose level) was reported in 881 individuals, 80 of whom were using insulin. Hip and spine bone mineral density (BMD) was measured using dual x-ray absorptiometry (DXA). After recruitment, the men were followed for incident non-vertebral fractures using a triannual (3 yearly) questionnaire for an average of 9.1 (SD 2.7) years. The Cox proportional hazards model was used to assess the incident risk of fractures. Results In models adjusted for age, race, clinic site and total hip BMD, the risk of non-vertebral fracture was higher in men with diabetes compared with normoglycaemic men (HR 1.30, 95%CI 1.09, 1.54) and was elevated inmen using insulin (HR 2.46, 95% CI 1.69, 3.59). Men with impaired fasting glucose did not have a higher risk of fracture compared with normoglycaemic men (HR 1.04, 95% CI 0.89, 1.21). After multivariable adjustment, the risk of non-vertebral fracture remained higher only among men with diabetes who were using insulin (HR 1.74, 95% CI 1.13, 2.69). Conclusions/interpretation Men with diabetes who are using insulin have an increased risk of non-vertebral fracture for a given age and BMD.

Original languageEnglish (US)
Pages (from-to)2057-2065
Number of pages9
JournalDiabetologia
Volume57
Issue number10
DOIs
StatePublished - 2014

Fingerprint

Pelvic Bones
Bone Density
Insulin
Fasting
Risk Adjustment
Glucose
Osteoporotic Fractures
Proportional Hazards Models
Self Report
Diabetes Mellitus
Spine
X-Rays
Surveys and Questionnaires

Keywords

  • Bone
  • Diabetes
  • Fractures
  • Impaired fasting glucose
  • Insulin
  • Osteoporosis

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Napoli, N., Strotmeyer, E. S., Ensrud, K. E., Sellmeyer, D. E., Bauer, D. C., Hoffman, A. R., ... Schwartz, A. V. (2014). Fracture risk in diabetic elderly men: The MrOS study. Diabetologia, 57(10), 2057-2065. https://doi.org/10.1007/s00125-014-3289-6

Fracture risk in diabetic elderly men : The MrOS study. / Napoli, Nicola; Strotmeyer, Elsa S.; Ensrud, Kristine E.; Sellmeyer, Deborah E.; Bauer, Douglas C.; Hoffman, Andrew R.; Dam, Thuy Tien L; Barrett-Connor, Elizabeth; Palermo, Lisa; Orwoll, Eric; Cummings, Steven R.; Black, Dennis M.; Schwartz, Ann V.

In: Diabetologia, Vol. 57, No. 10, 2014, p. 2057-2065.

Research output: Contribution to journalArticle

Napoli, N, Strotmeyer, ES, Ensrud, KE, Sellmeyer, DE, Bauer, DC, Hoffman, AR, Dam, TTL, Barrett-Connor, E, Palermo, L, Orwoll, E, Cummings, SR, Black, DM & Schwartz, AV 2014, 'Fracture risk in diabetic elderly men: The MrOS study', Diabetologia, vol. 57, no. 10, pp. 2057-2065. https://doi.org/10.1007/s00125-014-3289-6
Napoli N, Strotmeyer ES, Ensrud KE, Sellmeyer DE, Bauer DC, Hoffman AR et al. Fracture risk in diabetic elderly men: The MrOS study. Diabetologia. 2014;57(10):2057-2065. https://doi.org/10.1007/s00125-014-3289-6
Napoli, Nicola ; Strotmeyer, Elsa S. ; Ensrud, Kristine E. ; Sellmeyer, Deborah E. ; Bauer, Douglas C. ; Hoffman, Andrew R. ; Dam, Thuy Tien L ; Barrett-Connor, Elizabeth ; Palermo, Lisa ; Orwoll, Eric ; Cummings, Steven R. ; Black, Dennis M. ; Schwartz, Ann V. / Fracture risk in diabetic elderly men : The MrOS study. In: Diabetologia. 2014 ; Vol. 57, No. 10. pp. 2057-2065.
@article{ba923313bf4646dc88850d50b99ec8ec,
title = "Fracture risk in diabetic elderly men: The MrOS study",
abstract = "Aims/hypothesis Diabetes mellitus is associated with increased fracture risk in women but few studies are available in men. To evaluate the relationship between diabetes and prospective non-vertebral fractures in elderly men, we used data from the Osteoporotic Fractures in Men (MrOS) study. Methods The MrOS enrolled 5,994 men (aged ≥65 years). Diabetes (ascertained by self-report, the use of medication for diabetes or an elevated fasting glucose level) was reported in 881 individuals, 80 of whom were using insulin. Hip and spine bone mineral density (BMD) was measured using dual x-ray absorptiometry (DXA). After recruitment, the men were followed for incident non-vertebral fractures using a triannual (3 yearly) questionnaire for an average of 9.1 (SD 2.7) years. The Cox proportional hazards model was used to assess the incident risk of fractures. Results In models adjusted for age, race, clinic site and total hip BMD, the risk of non-vertebral fracture was higher in men with diabetes compared with normoglycaemic men (HR 1.30, 95{\%}CI 1.09, 1.54) and was elevated inmen using insulin (HR 2.46, 95{\%} CI 1.69, 3.59). Men with impaired fasting glucose did not have a higher risk of fracture compared with normoglycaemic men (HR 1.04, 95{\%} CI 0.89, 1.21). After multivariable adjustment, the risk of non-vertebral fracture remained higher only among men with diabetes who were using insulin (HR 1.74, 95{\%} CI 1.13, 2.69). Conclusions/interpretation Men with diabetes who are using insulin have an increased risk of non-vertebral fracture for a given age and BMD.",
keywords = "Bone, Diabetes, Fractures, Impaired fasting glucose, Insulin, Osteoporosis",
author = "Nicola Napoli and Strotmeyer, {Elsa S.} and Ensrud, {Kristine E.} and Sellmeyer, {Deborah E.} and Bauer, {Douglas C.} and Hoffman, {Andrew R.} and Dam, {Thuy Tien L} and Elizabeth Barrett-Connor and Lisa Palermo and Eric Orwoll and Cummings, {Steven R.} and Black, {Dennis M.} and Schwartz, {Ann V.}",
year = "2014",
doi = "10.1007/s00125-014-3289-6",
language = "English (US)",
volume = "57",
pages = "2057--2065",
journal = "Diabetologia",
issn = "0012-186X",
publisher = "Springer Verlag",
number = "10",

}

TY - JOUR

T1 - Fracture risk in diabetic elderly men

T2 - The MrOS study

AU - Napoli, Nicola

AU - Strotmeyer, Elsa S.

AU - Ensrud, Kristine E.

AU - Sellmeyer, Deborah E.

AU - Bauer, Douglas C.

AU - Hoffman, Andrew R.

AU - Dam, Thuy Tien L

AU - Barrett-Connor, Elizabeth

AU - Palermo, Lisa

AU - Orwoll, Eric

AU - Cummings, Steven R.

AU - Black, Dennis M.

AU - Schwartz, Ann V.

PY - 2014

Y1 - 2014

N2 - Aims/hypothesis Diabetes mellitus is associated with increased fracture risk in women but few studies are available in men. To evaluate the relationship between diabetes and prospective non-vertebral fractures in elderly men, we used data from the Osteoporotic Fractures in Men (MrOS) study. Methods The MrOS enrolled 5,994 men (aged ≥65 years). Diabetes (ascertained by self-report, the use of medication for diabetes or an elevated fasting glucose level) was reported in 881 individuals, 80 of whom were using insulin. Hip and spine bone mineral density (BMD) was measured using dual x-ray absorptiometry (DXA). After recruitment, the men were followed for incident non-vertebral fractures using a triannual (3 yearly) questionnaire for an average of 9.1 (SD 2.7) years. The Cox proportional hazards model was used to assess the incident risk of fractures. Results In models adjusted for age, race, clinic site and total hip BMD, the risk of non-vertebral fracture was higher in men with diabetes compared with normoglycaemic men (HR 1.30, 95%CI 1.09, 1.54) and was elevated inmen using insulin (HR 2.46, 95% CI 1.69, 3.59). Men with impaired fasting glucose did not have a higher risk of fracture compared with normoglycaemic men (HR 1.04, 95% CI 0.89, 1.21). After multivariable adjustment, the risk of non-vertebral fracture remained higher only among men with diabetes who were using insulin (HR 1.74, 95% CI 1.13, 2.69). Conclusions/interpretation Men with diabetes who are using insulin have an increased risk of non-vertebral fracture for a given age and BMD.

AB - Aims/hypothesis Diabetes mellitus is associated with increased fracture risk in women but few studies are available in men. To evaluate the relationship between diabetes and prospective non-vertebral fractures in elderly men, we used data from the Osteoporotic Fractures in Men (MrOS) study. Methods The MrOS enrolled 5,994 men (aged ≥65 years). Diabetes (ascertained by self-report, the use of medication for diabetes or an elevated fasting glucose level) was reported in 881 individuals, 80 of whom were using insulin. Hip and spine bone mineral density (BMD) was measured using dual x-ray absorptiometry (DXA). After recruitment, the men were followed for incident non-vertebral fractures using a triannual (3 yearly) questionnaire for an average of 9.1 (SD 2.7) years. The Cox proportional hazards model was used to assess the incident risk of fractures. Results In models adjusted for age, race, clinic site and total hip BMD, the risk of non-vertebral fracture was higher in men with diabetes compared with normoglycaemic men (HR 1.30, 95%CI 1.09, 1.54) and was elevated inmen using insulin (HR 2.46, 95% CI 1.69, 3.59). Men with impaired fasting glucose did not have a higher risk of fracture compared with normoglycaemic men (HR 1.04, 95% CI 0.89, 1.21). After multivariable adjustment, the risk of non-vertebral fracture remained higher only among men with diabetes who were using insulin (HR 1.74, 95% CI 1.13, 2.69). Conclusions/interpretation Men with diabetes who are using insulin have an increased risk of non-vertebral fracture for a given age and BMD.

KW - Bone

KW - Diabetes

KW - Fractures

KW - Impaired fasting glucose

KW - Insulin

KW - Osteoporosis

UR - http://www.scopus.com/inward/record.url?scp=84926654359&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84926654359&partnerID=8YFLogxK

U2 - 10.1007/s00125-014-3289-6

DO - 10.1007/s00125-014-3289-6

M3 - Article

VL - 57

SP - 2057

EP - 2065

JO - Diabetologia

JF - Diabetologia

SN - 0012-186X

IS - 10

ER -