Potential Explanatory Factors for Higher Incident Hip Fracture Risk in Older Diabetic Adults

Abstract EN

Type 2 diabetes is associated with higher fracture risk.

Diabetes-related conditions may account for this risk.

Cardiovascular Health Study participants (N=5641; 42.0% men; 15.5% black; 72.8±5.6 years) were followed 10.9 ± 4.6 years.

Diabetes was defined as hypoglycemic medication use or fasting glucose (FG) ≥126 mg/dL.

Peripheral artery disease (PAD) was defined as ankle-arm index <0.9.

Incident hip fractures were from medical records.

Crude hip fracture rates (/1000 person-years) were higher for diabetic vs.

non-diabetic participants with BMI <25 (13.6, 95% CI: 8.9–20.2 versus 11.4, 95% CI: 10.1–12.9) and BMI ≥25 to <30 (8.3, 95% CI: 5.7–11.9 versus 6.6, 95% CI: 5.6–7.7), but similar for BMI ≥30.

Adjusting for BMI, sex, race, and age, diabetes was related to fractures (HR = 1.34; 95% CI: 1.01–1.78).

PAD (HR = 1.25 (95% CI: 0.92–1.57)) and longer walk time (HR = 1.07 (95% CI: 1.04–1.10)) modified the fracture risk in diabetes (HR = 1.17 (95% CI: 0.87–1.57)).

Diabetes was associated with higher hip fracture risk after adjusting for BMI though this association was modified by diabetes-related conditions.