Purpose: The aim of this 5-year prospective study was to investigate the association between type 2 diabetes mellitus (T2DM) and incident osteoporotic fracture (IOF) in Chinese postmenopausal women aged 50 years or older.
Methods: We included 826 subjects, participating in both the baseline (20072008) and follow-up (20122013) studies. Based on the diagnosis of T2DM, subjects were first individualized into Non-T2DM and T2DM groups, which were then categorized, based on the history of previous osteoporotic fractures (POFs) before baseline, into four subgroups: Non-T2DM+Non-POF, Non-T2DM+POF, T2DM+Non-POF and T2DM+POF. Risks of IOFs and baseline values of bone mineral density (BMD) and bone turnover markers (BTMs), were compared between groups. Based on the fracture site, IOFs were further classified into major osteoporotic fracture (MOF) and non-MOF, incidences of which were also compared.
Results: Diabetic subjects, especially those without POF, had significantly lower levels of BTMs but non-decreased values of BMDs than non-diabetic subjects. Comparing to Non-T2DM group, fracture incidence was increased 1.773-fold (95%CI, 0.8873.544) for IOF and 4.091-fold (95%CI, 1.65310.120) for Non-MOF in T2DM group. Comparing to Non-T2DM+Non-POF subgroup, fracture incidence was increased 2.561-fold (95%CI, 1.1085.922) for IOF and 5.595-fold (95%CI, 1.88316.621) for Non-MOF in T2DM+Non-POF subgroup. Although no statistical significance existed, fracture incidence of T2DM+Non-POF subgroup was comparable to Non-T2DM+POF subgroup, and T2DM+POF subgroup had a higher fracture incidence than Non-T2DM+POF subgroup. Low BTMs were not found significantly associated with high incidence of IOFs in T2DM+Non-POF subgroup.
Conclusions: T2DM was such an important risk factor as previous factures for incident osteoporotic fractures in Chinese postmenopausal women. Except for bone turnover, there might be additional mechanisms contributing to the increased incidence of IOFs in type 2 diabetic patients.
14 May 2016 - 17 May 2016