Diabetic Patients Have an Increased Risk of Vertebral Fractures Independent of BMD or Diabetic Complications

Yamamoto, Masahiro; Yamaguchi, Toru; Yamauchi, Mika; Kaji, Hiroshi; Sugimoto, Toshitsugu

doi:10.1359/jbmr.081207

Cited by 295 publications

(211 citation statements)

References 43 publications

Supporting

Mentioning

188

Contrasting

Unclassified

Order By: Relevance

“…Patient histories of nonVFs that previously happened are also established risk factors for additional fractures [99]. We found that 38% of T2DM men and 31% of T2DM women had prevalent VFs by X-ray films, and that 16% each of T2DM men and women had histories of previous nonVFs [32]. Thus, if T2DM patients undergo spine X-ray examination or are questioned about their fracture histories, it is likely that about half of them are picked up as those who have bone fragility and need osteoporosis treatment for fracture prevention.…”

Section: Fracture Risk Assessment Of T2dm Patients In Clinical Prmentioning

confidence: 75%

“…In contrast, it is little known about VF risk and its association with BMD. We examined Japanese T2DM patients and non-DM controls about this issue [31,32]. We found that the presence of T2DM was an independent risk factor for prevalent VFs in women [odds ratio (OR)=1.9] as well as men (OR=4.7) after adjustment for age, BMI, and lumbar BMD by logistic regression analysis.…”

Section: The Involvement Of Fat Tissue In Bone Metabolism Throughmentioning

confidence: 99%

See 1 more Smart Citation

Bone metabolism and fracture risk in type 2 diabetes mellitus [Review]

Yamaguchi

Sugimoto

2011

Endocr J

Self Cite

View full text Add to dashboard Cite

Abstract. Osteoporosis and type 2 diabetes mellitus (T2DM) are now prevalent in aging and westernized societies, and adversely affect the health of the elderly people by causing fractures and vascular complications, respectively. Recent experimental and clinical studies show that both disorders are etiologically related to each other through the actions of osteocalcin and adiponectin. Meta-analyses of multiple clinical studies show that hip fracture risk of T2DM patients is increased to 1.4 to 1.7-folds, although BMD of the patients is not diminished. Vertebral fracture risk of T2DM patients is also increased, and BMD is not useful for assessing its risk. These findings suggest that bone fragility in T2DM depends on bone quality deterioration rather than bone mass reduction. Thus, surrogate markers are needed to replace the insensitivity of BMD in assessing fracture risks of T2DM patients. Markers related to advanced glycation end products as well as insulinlike growth factor-I may be such candidates, because these substances were experimentally shown to modulate bone quality in DM. In practice, it is important for physicians to assess fracture risk in T2DM patients by evaluating prior VFs and fracture histories using spine X-ray and interview, respectively, until the usefulness of surrogate markers is established. Key words: Type 2 diabetes mellitus, Bone fragility, Fracture risk, Osteocalcin, AdiponectinThe numbers of patients with osteoporosis or type 2 diabetes mellitus (T2DM) are increasing in aging and westernized societies. Both disorders predispose the elderly people to disabled conditions by causing fractures and vascular complications, respectively, which eventually raise their mortality. Although osteoporosis and T2DM are traditionally viewed as separate disease entities, accumulating evidence indicates that there are similar pathophysiological mechanisms underlying them. I. Interaction between bone metabolism and glucose/fat metabolism through osteocalcin and Wnt signalingOsteocalcin (OC), one of the osteoblast-specific secreted proteins, has several hormonal features and is secreted in the general circulation from osteoblasts [1,2]. Recent animal studies have shown that OC action is related to not only bone metabolism but also glucose metabolism and fat mass [3,4]. Lee et al. showed that OC functions as a hormone that improves glucose metabolism and reduces fat mass, because OC-deficient mouse aggravated these processes [3]. Moreover, Ferron et al. showed that recombinant uncarboxylated OC administration to wild-type mice fed by high fat diet regulated gene expression in pancreatic β cells and adipocytes (including adiponectin expression), and prevented the development of metabolic diseases, obesity, and hyperglycemia [4]. Several clinical studies have also confirmed the relationship between OC and glucose/fat metabolism in humans [5][6][7][8][9]. We were the first to show that serum OC level was negatively correlated with plasma glucose level and atherosclerosis parameters in T2DM patients [5]. We ...

show abstract

Section: Fracture Risk Assessment Of T2dm Patients In Clinical Prmentioning

confidence: 75%

Section: The Involvement Of Fat Tissue In Bone Metabolism Throughmentioning

confidence: 99%

Bone metabolism and fracture risk in type 2 diabetes mellitus [Review]

Yamaguchi

Sugimoto

2011

Endocr J

Self Cite

View full text Add to dashboard Cite

show abstract

“…(16) Another group reported that the presence of T2DM was an independent risk factor for prevalent VFs in Japanese men aged 50 years and older (OR, 4.73; 95% CI, 2.19 to 10.2) after adjusting for age, BMI, and lumbar spine BMD. (20) Because VFs are a major cause of pain and disability, (36,37) it is important to identify subjects at increased risk of VFs. In the present analysis, having diabetes was not statistically significantly associated with increased odds of prevalent or incident VFs.…”

Section: Discussionmentioning

confidence: 99%

“…(6,15,16) To date, information on VF risk in T2DM men is very limited and conflicting, and mostly based on prevalent VFs. (16)(17)(18)(19)(20) Thus, it is still not clear whether VF risk is increased in men with T2DM.…”

Section: Introductionmentioning

confidence: 99%

Vertebral Fracture Risk in Diabetic Elderly Men: The MrOS Study

Napoli

Schwartz²,

Schafer

et al. 2017

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

Type 2 diabetes (T2DM) is associated with a significant increase in risk of nonvertebral fractures, but information on risk of vertebral fractures (VFs) in subjects with T2DM, particularly among men, is lacking. Furthermore, it is not known whether spine bone mineral density (BMD) can predict the risk of VF in T2DM. We sought to examine the effect of diabetes status on prevalent and incident vertebral fracture, and to estimate the effect of lumbar spine BMD (areal and volumetric) as a risk factor for prevalent and incident morphometric vertebral fracture in T2DM (n ¼ 875) and nondiabetic men (n ¼ 4679). We used data from the Osteoporotic Fractures in Men (MrOS) Study, which enrolled men aged !65 years. Lumbar spine areal BMD (aBMD) was measured with dual-energy X-ray absorptiometry (DXA), and volumetric BMD (vBMD) by quantitative computed tomography (QCT). Prevalence (7.0% versus 7.7%) and incidence (4.4% versus 4.5%) of VFs were not higher in T2DM versus nondiabetic men. The risk of prevalent (OR, 1.05; 95% CI, 0.78 to 1.40) or incident vertebral-fracture (OR, 1.28; 95% CI, 0.81 to 2.00) was not higher in T2DM versus nondiabetic men in models adjusted for age, clinic site, race, BMI, and aBMD. Higher spine aBMD was associated with lower risk of prevalent VF in T2DM (OR, 0.55; 95% CI, 0.48 to 0.63) and nondiabetic men (OR, 0.66; 95% CI, 0.5 to 0.88) (p for interaction ¼ 0.24) and of incident VF in T2DM (OR, 0.50; 95% CI, 0.41 to 0.60) and nondiabetic men (OR, 0.54; 95% CI, 0.33 to 0.88) (p for interaction ¼ 0.77). Results were similar for vBMD. In conclusion, T2DM was not associated with higher prevalent or incident VF in older men, even after adjustment for BMI and BMD. Higher spine aBMD and vBMD are associated with lower prevalence and incidence of VF in T2DM as well as nondiabetic men.

show abstract

“…There is now a growing body of evidence that the incidence of these conditions is significantly increased in the presence of type 1 and 2 diabetes mellitus (DM) (1)(2)(3)(4)(5). Clinical data indicate that bone of diabetic patients is fragile and of poor quality, despite a bone mineral density (BMD) that is often normal.…”

Section: Introductionmentioning

confidence: 99%