| Title: | Degree of Joint Risk Factor Control and Incident Fracture Outcomes in Individuals With Type 2 Diabetes |
| Journal: | The Journal of Clinical Endocrinology & Metabolism |
| Published: | 13 Mar 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/40080700/ |
| DOI: | https://doi.org/10.1210/clinem/dgaf172 |
Publication 15607
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Abstract
CONTEXT: Individuals with type 2 diabetes have a higher fracture risk than the general population. However, the association between joint risk factor control and fracture risk in this population remains unclear.</p>
OBJECTIVE: To investigate the extent to which joint risk factor control might attenuate the excess risk of fracture outcomes in individuals with type 2 diabetes.</p>
METHODS: We included 8935 individuals with type 2 diabetes and 35 740 matched controls without fractures at baseline from the UK Biobank (UKB), with a median follow-up of 12.1 years. Six modifiable risk factors were assessed: body mass index (BMI), physical activity, smoking, alcohol consumption, serum 25-hydroxyvitamin D (25(OH)D), and glycated hemoglobin A1c (HbA1c). Cox proportional hazards models were used to estimate associations between risk factor control and fracture risk.</p>
RESULTS: Controlling each additional risk factor resulted in a 14% to 26% decrease in fracture risk. Optimal control (≥5 risk factors) correlated with a 50% reduction in overall fractures (HR 0.50; 95% CI 0.33-0.75). However, a 60% reduction in hip fractures (HR 0.40; 95% CI 0.16-0.98) was observed with the control of 4 risk factors. With control of 4 or more risk factors, fracture risk in individuals with type 2 diabetes was comparable to that of nondiabetic controls, and the protective effect was stronger in men than in women.</p>
CONCLUSION: Joint risk factor control was significantly linked to a reduced fracture risk, and optimal management may eliminate the excess fracture risk associated with type 2 diabetes.</p>
17 Keywords
- Aged
- Alcohol Drinking
- Body Mass Index
- Case-Control Studies
- Diabetes Mellitus, Type 2
- Exercise
- Female
- Follow-Up Studies
- Fractures, Bone
- Glycated Hemoglobin
- Humans
- Incidence
- Male
- Middle Aged
- Risk Factors
- United Kingdom
- Vitamin D
6 Authors
- Huan Huang
- Jie Cai
- Huaying Hu
- Lishan Cai
- Lu Qi
- Tao Zhou
1 Application
| Application ID | Title |
|---|---|
| 29256 | Study of gene-environment interaction and Mendelian randomization of obesity and cardiometabolic risk |
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