Title | Diabetes and risk of fracture-related hospitalization: the Atherosclerosis Risk in Communities Study. |
Publication Type | Journal Article |
Year of Publication | 2013 |
Authors | Schneider ALC, Williams EK, Brancati FL, Blecker S, Coresh J, Selvin E |
Journal | Diabetes Care |
Volume | 36 |
Issue | 5 |
Pagination | 1153-8 |
Date Published | 2013 May |
ISSN | 1935-5548 |
Keywords | Atherosclerosis, Blood Glucose, Diabetes Mellitus, Diabetes Mellitus, Type 2, Female, Fractures, Bone, Hospitalization, Humans, Incidence, Male, Middle Aged, Risk Factors |
Abstract | OBJECTIVE: To examine the association between diabetes, glycemic control, and risk of fracture-related hospitalization in the Atherosclerosis Risk in Communities (ARIC) Study. RESEARCH DESIGN AND METHODS: Fracture-related hospitalization was defined using International Classification of Diseases, 9th revision, codes (733.1-733.19, 733.93-733.98, or 800-829). We calculated the incidence rate of fracture-related hospitalization by age and used Cox proportional hazards models to investigate the association of diabetes with risk of fracture after adjustment for demographic, lifestyle, and behavioral risk factors. RESULTS: There were 1,078 incident fracture-related hospitalizations among 15,140 participants during a median of 20 years of follow-up. The overall incidence rate was 4.0 per 1,000 person-years (95% confidence interval [CI], 3.8-4.3). Diagnosed diabetes was significantly and independently associated with an increased risk of fracture (adjusted hazard ratio [HR], 1.74; 95% CI, 1.42-2.14). There also was a significantly increased risk of fracture among persons with diagnosed diabetes who were treated with insulin (HR, 1.87; 95% CI, 1.15-3.05) and among persons with diagnosed diabetes with hemoglobin A1c (HbA1c) ≥8% (1.63; 1.09-2.44) compared with those with HbA1c CONCLUSIONS: This study supports recommendations from the American Diabetes Association for assessment of fracture risk and implementation of prevention strategies in persons with type 2 diabetes, particularly those persons with poor glucose control. |
DOI | 10.2337/dc12-1168 |
Alternate Journal | Diabetes Care |
PubMed ID | 23248194 |
PubMed Central ID | PMC3631877 |
Grant List | HHSN268201100012C / HL / NHLBI NIH HHS / United States HHSN268201100009I / HL / NHLBI NIH HHS / United States HHSN268201100010C / HL / NHLBI NIH HHS / United States HHSN268201100008C / HL / NHLBI NIH HHS / United States R01 DK089174 / DK / NIDDK NIH HHS / United States HHSN268201100007C / HL / NHLBI NIH HHS / United States HHSN268201100011I / HL / NHLBI NIH HHS / United States K01 DK076595 / DK / NIDDK NIH HHS / United States HHSN268201100006C / HL / NHLBI NIH HHS / United States HHSN268201100005I / HL / NHLBI NIH HHS / United States HHSN268201100007I / HL / NHLBI NIH HHS / United States HHSN268201100005G / HL / NHLBI NIH HHS / United States HHSN268201100008I / HL / NHLBI NIH HHS / United States P30 DK079637 / DK / NIDDK NIH HHS / United States HHSN268201100011C / HL / NHLBI NIH HHS / United States HHSN268201100009C / HL / NHLBI NIH HHS / United States HHSN268201100005C / HL / NHLBI NIH HHS / United States T32 DK062707 / DK / NIDDK NIH HHS / United States R21 DK080294 / DK / NIDDK NIH HHS / United States |