(05-04-11) Glycaemic control is positively associated with prevalent fractures but not

Glycaemic control is positively associated with prevalent fractures but not bone mineral density in patients with 1 diabetes Type


Neumann T, S?mann A, Lodes S, K?stner B, Franke S, Kiehntopf M, Hemmelmann C,
Lehmann T, M?ller UA, Hein G, Wolf G.

Department of Medicine III Institute of Clinical Chemistry and Laboratory
Diagnostics Institute of Medical Statistics, Computer Sciences and
Documentation, University-Hospital Jena, Jena, Germany.
Abstract
There are conflicting data regarding the risk of Aim osteoporosis in patients
1 diabetes. We investigated an with Type association between diabetes, bone
mineral density and prevalent fractures. A single-centre, cross- Methods
sectional study of men and pre-menopausal 128) = 1 diabetes (n women with Type
77) = and a matched control group (n was conducted. The primary outcome measure
was bone mineral density and secondary measures were markers of bone metabolism
and prevalent fractures. Hip and total body bone mineral densities Results
were significantly lower in women with diabetes compared with control subjects.
In men, no difference in bone mineral density was found. A multivariate
regression analysis in women with diabetes revealed higher BMI as the strongest
predictor of higher total hip, femoral neck and total body bone mineral
density, whereas previous fractures were inversely associated with total hip
bone mineral I collagen with total density and C-terminal telopeptide of type
body bone mineral density. Poor long-term glycaemic control was not associated
with low bone mineral density. Fracture frequency was higher in patients with
diabetes compared with control subjects (1.64 vs. 0.62 per 100  patient-years; P
<0.05). In a multivariable model, long-term HbA(1c)  control was associated
with increased clinical fracture prevalence (OR 1.92; CI 1.09-2.75) in 95%
1 diabetes  Type those with diabetes. Conclusions contributes to low bone
mineral density in women. Previous fractures and low BMI were strong predictors
of impaired bone mineral density and should therefore be considered in risk
estimation. Fractures are more frequent in 1 diabetes. Long-term Type
hyperglycaemia may account for impaired bone strength, independently from bone
mineral density.

Source: Diabet Med. 2011 Mar 12. doi: 10.1111/j.1464-5491.2011.03286.x. [Epub ahead of
print]

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