Risk factors for hip fractures in a middle-aged population: a study of 33,000 men and women

Holmberg, Anna; Johnell, Olof; Nilsson, Peter M.; Nilsson, Jan‐Åke; Berglund, Göran; Åkesson, Kristina

doi:10.1007/s00198-005-2006-1

Cited by 78 publications

(78 citation statements)

References 43 publications

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“…(44) The observation that the risk of prevalent or incident VFs in elderly men with T2DM is not increased compared with men without DM is in contrast with the increased risk of hip fractures in patients with T2DM. (6)(7)(8)(9)(10)(11)(12) Our results show a trend for an increased risk of incident VF by 30% in aBMD-adjusted models, and the 95% CI extends to a doubling of risk. Thus, the limited number of incident fractures among diabetics in our cohort make it difficult to rule out a modest increased risk.…”

Section: Discussionsupporting

confidence: 50%

Vertebral Fracture Risk in Diabetic Elderly Men: The MrOS Study

Napoli

Schwartz²,

Schafer

et al. 2017

Journal of Bone and Mineral Research

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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.

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Section: Discussionsupporting

confidence: 50%

Vertebral Fracture Risk in Diabetic Elderly Men: The MrOS Study

Napoli

Schwartz²,

Schafer

et al. 2017

Journal of Bone and Mineral Research

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“…These data suggest together with other studies 32,33 that chronic alcohol consumption could be associated directly with the risk of hip fractures.…”

supporting

confidence: 84%

Characteristics of Hip Fractures Due to Minimal Trauma in Older People of a Health Area in Southwest Spain

Mayordomo¹

2017

MOJGG

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Osteoporotic hip fracture is one of the pathologies of the elderly with greatest morbidity and mortality, dependency, and health costs. Therefore, the objective of this study was to identify some of the determinants of minimal trauma hip fracture in patients of 65 or older. A descriptive, prospective, transversal study was conducted based on a structured survey addressed to the 233 patients admitted to the Virgen del Puerto Hospital for hip fracture in two years. The patients belonged to a health care zone of 70 rural municipalities (Plasencia, Cáceres, Spain) in the years 2007 and 2008. The largest number of fractures occurred in women of >80 years (p=0.005) when they were turning around or standing up or sitting down, did not use elements of support for walking (p<0.005), had suffered some previous fracture (p=0.0005), led a sedentary lifestyle, had calcium-poor diets, and lacked health information on this pathology and its prevention. These results allowed identifying the characteristics of hip fractures as women older than 80, with a sedentary lifestyle, a calcium intake below recommended levels and who resist using canes or crutches as aids to walking.

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“…In a Norwegian study (3), an increased risk of hip fracture was found in type 2 diabetic women aged between 50 and 74 years with Ͼ5 years duration of diabetes (HR 1.8 [95% CI 1.1-2.9]), but there was no significantly increased risk of hip fracture in diabetic patients aged Ͼ75 years (1.41 [0.9 -2.1]). In their studies, Meyer et al (2) and Holmberg et al (6) recruited only middle-aged subjects and reported a significantly increased risk of hip fracture in diabetic patients. The study by Dobnig et al (20), who included only individuals aged Ͼ70 years, however, showed a HR for hip fracture of 0.90 (95% CI 0.60 -1.34), adjusted for age and weight, a result that is quite similar to the HRs reported in our study for the oldest age-groups.…”

Section: Results -The Meanmentioning

confidence: 99%

“…Diabetic patients, who have already been crippled by various microvascular and macrovascular complications, were reported to have increased risks of hip fracture (2)(3)(4)(5)(6)(7)(8)(9)(10). Much of the previous research, however, focused on women (4,5,8) or on older patients aged Ͼ65 years (4,9) so that relatively few data were available for specific risks in various agegroups and sex groups.…”

mentioning

confidence: 99%

Increased Risks of Hip Fracture in Diabetic Patients of Taiwan

Chen

Ho²,

2008

Diabetes Care

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OBJECTIVE -Using Taiwan's National Health Insurance claim data, we evaluated the age-, sex-, and urbanization-specific incidence density and relative risks of hip fracture in the diabetic population.RESEARCH DESIGN AND METHODS -Diabetic patients (n ϭ 500,868) and an ageand sex-matched control group (n ϭ 500,248) were linked to inpatient claims (1997)(1998)(1999)(2000)(2001)(2002) to identify hospitalizations for nontransport accident hip fracture. The person-year approach with Poisson assumption and Kaplan-Meier analysis were used to estimate the incidence and the cumulative event rates. We also assessed the age-, sex-, and urbanization-specific relative risks of hip fracture in relation to diabetes with the Cox proportional hazard regression model. RESULTS-The overall incidences of hip fracture for diabetic men and women, respectively, were 3.01 and 6.75/1,000 person-years, which were higher than those for control men and women. There were significant interactions of diabetes and age and diabetes and urbanization statuses. Hazard ratios (HRs) of diabetic patients aged 35-44 years (men 2.45 [95% CI 1.65-3.64]; women 3.19 [1.39 -7.33]) were higher than those of diabetic patients aged 55-64 years (men 1.90; women 2.81), but in diabetic men aged Ͼ74 years and diabetic women aged Ͼ84 years, the HRs were compared with null statistically (HRs 0.98 and 0.91, respectively). Diabetic patients living in rural areas tended to have higher HRs of hip fracture.CONCLUSIONS -In Taiwan, diabetes increased the risk of hip fracture in both sexes in all age-groups except in diabetic men aged Ͼ74 years and diabetic women aged Ͼ84 years. Higher HRs of hip fracture were disproportionately observed in younger diabetic patients and in those living in rural areas. Diabetes Care 31:75-80, 2008T he incidence of hip fracture is expected to increase worldwide (1), and subsequent functional disability, morbidity, and mortality contribute tremendous health problems to our society. Diabetic patients, who have already been crippled by various microvascular and macrovascular complications, were reported to have increased risks of hip fracture (2-10). Much of the previous research, however, focused on women (4,5,8) or on older patients aged Ͼ65 years (4,9) so that relatively few data were available for specific risks in various agegroups and sex groups. Nearly all published studies were conducted in whites (10), and little information is available for Asian diabetic populations. Moreover, a recent study indicated that the relative risk of macrovascular disease associated with diabetes showed a significant geographic variation in Taiwan, implying a differential quality of care delivered to the diabetic patients in certain areas (11). No study so far has been conducted to investigate whether there is an urban-rural difference in incidence and relative risk of hip fracture in diabetic patients. In Taiwan, the high incidence (12) of hip fracture in the general population was reported previously, but the incidence of hip fracture among diabetic patient...

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Risk factors for hip fractures in a middle-aged population: a study of 33,000 men and women

Abstract: Publisher: Springer.Use of alternative location to go to the published version of the article requires journal subscription.

Cited by 78 publications

References 43 publications

Vertebral Fracture Risk in Diabetic Elderly Men: The MrOS Study

Vertebral Fracture Risk in Diabetic Elderly Men: The MrOS Study

Characteristics of Hip Fractures Due to Minimal Trauma in Older People of a Health Area in Southwest Spain

Increased Risks of Hip Fracture in Diabetic Patients of Taiwan

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