(05-06-10) Diabetes Mellitus and Risk of Hip Fracture in the Singapore Chinese Health Study.

Koh WP, Wang R, Ang LW, Heng D, Yuan JM, Yu MC.


1. Department of Epidemiology and Public Health, Yong Loo Lin School of
Medicine, National University of Singapore, Singapore.
Abstract
AbstractObjective - Asian populations are documenting rapid increase in the
rates of diabetes mellitus and hip fracture but there is no prospective data
linking both diseases in Asian studies. We investigated this association among
a cohort of Chinese in Singapore. Research design and methods - A prospective
cohort of 63,257 Chinese in the Singapore Chinese Health Study, established
between 1993 and 1998, was followed up for a mean duration of 12 years.
Diabetes status was ascertained by baseline interviews, and incidence of hip
fracture post enrollment was identified through nationwide hospital discharge
database. Results - The risk of hip fracture, after adjustment for other risk
factors, was almost twice among people with diabetes compared to those without
[relative risk 1.98, 95% confidence interval (CI) 1.71-2.29]. When stratified
by body mass index, the increase in risk of hip fracture among people with
diabetes relative to those without diabetes was similar in all 4 strata. There
was a very strong dose-dependent relationship between duration of diabetes and
risk of hip fracture (P for trend <0.0001). Compared to people without
diabetes, the relative risk (95% CI) among subjects with diabetes for less than
5 years at recruitment was 1.40 (1.08-1.82) and this risk increased to 2.66
(2.04-3.47) among those with diabetes for 15 or more years. Conclusion - Asians
with diabetes, like their Western counterparts, experience an increased risk of
hip fracture. Early assessment for osteoporosis and increased fracture risk, as
well as prevention of falls, should be part of the management of diabetes.

Source : Diabetes Care. 2010 May 26.

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