Pulse lineResearch With Heart Logo

Diabetes and risk of fracture-related hospitalization: the Atherosclerosis Risk in Communities Study.

TitleDiabetes and risk of fracture-related hospitalization: the Atherosclerosis Risk in Communities Study.
Publication TypeJournal Article
Year of Publication2013
AuthorsSchneider ALC, Williams EK, Brancati FL, Blecker S, Coresh JJ
Secondary AuthorsSelvin E
JournalDiabetes Care
Volume36
Issue5
Pagination1153-8
Date Published2013 May
ISSN1935-5548
KeywordsAtherosclerosis, 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.

DOI10.2337/dc12-1168
Alternate JournalDiabetes Care
PubMed ID23248194
PubMed Central IDPMC3631877
Grant ListHHSN268201100012C / 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
HHSN268201100005G / HL / NHLBI NIH HHS / United States
HHSN268201100008I / HL / NHLBI NIH HHS / United States
HHSN268201100005C / / PHS HHS / United States
R01 DK089174 / DK / NIDDK NIH HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
HHSN268201100009C / / PHS HHS / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
P30 DK079637 / DK / NIDDK NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
HHSN268201100010C / / PHS HHS / United States
K01 DK076595 / DK / NIDDK NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / / PHS HHS / United States
HHSN268201100012C / / PHS HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
HHSN268201100007C / / PHS HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100011C / / PHS HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States
T32 DK062707 / DK / NIDDK NIH HHS / United States
R21 DK080294 / DK / NIDDK NIH HHS / United States
HHSN268201100006C / / PHS HHS / United States