High Bone Mineral Density and Fracture Risk in Type 2 Diabetes as Skeletal Complications of Inadequate Glucose Control: The Rotterdam Study
Ling Oei,M. Carola Zillikens,Abbas Dehghan,Gabriëlle H.S. Buitendijk,Martha C. Castaño-Betancourt,Karol Estrada,Lisette Stolk,Edwin H.G. Oei,Joyce B. J. van Meurs,Joseph A M J L Janssen,Albert Hofman,Johannes P.T.M. van Leeuwen,Jacqueline C.M. Witteman,Huibert A. P. Pols,André G. Uitterlinden,Caroline C W Klaver,Oscar H. Franco,Fernando Rivadeneira +17 more
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TLDR
Poor glycemic control in type 2 diabetes is associated with fracture risk, high BMD, and thicker femoral cortices in narrower bones, and it is postulate that fragility in apparently “strong” bones in ICD can result from microcrack accumulation and/or cortical porosity, reflecting impaired bone repair.Abstract:
OBJECTIVEdIndividuals with type 2 diabetes have increased fracture risk despite higher bonemineraldensity(BMD).Ouraimwastoexaminetheinfluenceofglucosecontrolonskeletal complications. RESEARCH DESIGN AND METHODSdData of 4,135 participants of the Rotterdam Study, a prospective population-based cohort, were available (mean follow-up 12.2 years). At baseline, 420 participants with type 2 diabetes were classified by glucose control (according to HbA1c calculated from fructosamine), resulting in three comparison groups: adequately controlled diabetes (ACD; n = 203; HbA1c ,7.5%), inadequately controlled diabetes (ICD; n = 217; HbA1c $7.5%), and no diabetes (n = 3,715). Models adjusted for sex, age, height, and weight (and femoral neck BMD) were used to test for differences in bone parameters and fracture risk (hazard ratio [HR] [95% CI]).read more
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