Fracture risk in diabetic elderly men: the MrOS study
Nicola Napoli1, Elsa S Strotmeyer, Kristine E Ensrud
1Division of Endocrinology and Diabetes, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Rome, Italy, n.napoli@unicampus.it.
Diabetologia
|June 9, 2014
Summary
Elderly men with diabetes, particularly those using insulin, face a higher risk of non-vertebral fractures. This increased fracture risk is significant even after accounting for age and bone density.
Area of Science:
- Gerontology
- Endocrinology
- Orthopedics
Background:
- Diabetes mellitus is a known risk factor for fractures in women.
- Limited research exists on the fracture risk associated with diabetes in men.
Purpose of the Study:
- To investigate the association between diabetes and the risk of non-vertebral fractures in elderly men.
- To determine if insulin use modifies this risk.
Main Methods:
- Utilized data from the Osteoporotic Fractures in Men (MrOS) study, including 5,994 men aged 65 and older.
- Assessed diabetes status via self-report, medication use, or fasting glucose levels.
- Measured bone mineral density (BMD) and followed participants for incident non-vertebral fractures over an average of 9.1 years, using Cox proportional hazards models.
Main Results:
- Men with diabetes had a higher risk of non-vertebral fractures (HR 1.30) compared to normoglycemic men.
- Men with diabetes using insulin showed a significantly elevated risk (HR 2.46).
- After multivariable adjustment, only men with diabetes using insulin maintained a significantly higher risk (HR 1.74).
Conclusions:
- Diabetes is associated with an increased risk of non-vertebral fractures in elderly men.
- Insulin use in diabetic men is a key factor contributing to this elevated fracture risk, independent of age and BMD.
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