Fracture risk in diabetic elderly men: the MrOS study
Identifieur interne : 005766 ( Main/Merge ); précédent : 005765; suivant : 005767Fracture risk in diabetic elderly men: the MrOS study
Auteurs : Nicola Napoli [États-Unis] ; Elsa S. Strotmeyer [États-Unis] ; Kristine E. Ensrud [États-Unis] ; Deborah E. Sellmeyer [États-Unis] ; Douglas C. Bauer [États-Unis] ; Andrew R. Hoffman [États-Unis] ; Thuy-Tien L. Dam [États-Unis] ; Elizabeth Barrett-Connor [États-Unis] ; Lisa Palermo [États-Unis] ; Eric S. Orwoll [États-Unis] ; Steven R. Cummings [États-Unis] ; Dennis M. Black [États-Unis] ; Ann V. Schwartz [États-Unis]Source :
- Diabetologia : (Berlin) [ 0012-186X ] ; 2014.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme, Glucose, Diabète, Personne âgée.
English descriptors
- KwdEn :
Abstract
Aims/hypothesis Diabetes mellitus is associated with increased fracture risk in women but few studies are available in men. To evaluate the relationship between diabetes and prospective non-vertebral fractures in elderly men, we used data from the Osteoporotic Fractures in Men (MrOS) study. Methods The MrOS enrolled 5,994 men (aged >65 years). Diabetes (ascertained by self-report, the use of medication for diabetes or an elevated fasting glucose level) was reported in 881 individuals, 80 of whom were using insulin. Hip and spine bone mineral density (BMD) was measured using dual x-ray absorptiometry (DXA). After recruitment, the men were followed for incident non-vertebral fractures using a triannual (3 yearly) questionnaire for an average of 9.1 (SD 2.7) years. The Cox proportional hazards model was used to assess the incident risk of fractures. Results In models adjusted for age, race, clinic site and total hip BMD, the risk of non-vertebral fracture was higher in men with diabetes compared with normoglycaemic men (HR 1.30, 95% CI 1.09, 1.54) and was elevated in men using insulin (HR 2.46, 95% CI 1.69, 3.59). Men with impaired fasting glucose did not have a higher risk of fracture compared with normoglycaemic men (HR 1.04, 95% CI 0.89, 1.21). After multivariable adjustment, the risk of non-vertebral fracture remained higher only among men with diabetes who were using insulin (HR 1.74, 95% CI 1.13, 2.69). Conclusions/interpretation Men with diabetes who are using insulin have an increased risk of non-vertebral fracture for a given age and BMD.
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Dam</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>University of California, San Diego</s1><s2>La Jolla, CA</s2><s3>USA</s3><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">San Diego</settlement><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Barrett Connor, Elizabeth" sort="Barrett Connor, Elizabeth" uniqKey="Barrett Connor E" first="Elizabeth" last="Barrett-Connor">Elizabeth Barrett-Connor</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>University of California, San Diego</s1><s2>La Jolla, CA</s2><s3>USA</s3><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">San Diego</settlement><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Palermo, Lisa" sort="Palermo, Lisa" uniqKey="Palermo L" first="Lisa" last="Palermo">Lisa Palermo</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>University of California, San Francisco</s1><s2>San Francisco, CA</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">San Francisco</settlement><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Orwoll, Eric S" sort="Orwoll, Eric S" uniqKey="Orwoll E" first="Eric S." last="Orwoll">Eric S. Orwoll</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Oregon Health & Science University</s1><s2>Portland, OR</s2><s3>USA</s3><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Oregon Health & Science University</wicri:noRegion></affiliation></author><author><name sortKey="Cummings, Steven R" sort="Cummings, Steven R" uniqKey="Cummings S" first="Steven R." last="Cummings">Steven R. Cummings</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>California Pacific Medical Center</s1><s2>San Francisco, CA</s2><s3>USA</s3><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>California Pacific Medical Center</wicri:noRegion></affiliation></author><author><name sortKey="Black, Dennis M" sort="Black, Dennis M" uniqKey="Black D" first="Dennis M." last="Black">Dennis M. 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Schwartz</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>University of California, San Francisco</s1><s2>San Francisco, CA</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">San Francisco</settlement><region type="state">Californie</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">14-0243394</idno><date when="2014">2014</date><idno type="stanalyst">PASCAL 14-0243394 INIST</idno><idno type="RBID">Pascal:14-0243394</idno><idno type="wicri:Area/PascalFrancis/Corpus">000541</idno><idno type="wicri:Area/PascalFrancis/Curation">004095</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000843</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000843</idno><idno type="wicri:doubleKey">0012-186X:2014:Napoli N:fracture:risk:in</idno><idno type="wicri:Area/Main/Merge">005766</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Fracture risk in diabetic elderly men: the MrOS study</title><author><name sortKey="Napoli, Nicola" sort="Napoli, Nicola" uniqKey="Napoli N" first="Nicola" last="Napoli">Nicola Napoli</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Division of Bone and Mineral Diseases, Washington University</s1><s2>St Louis, MO</s2><s3>USA</s3><sZ>1 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>St Louis, MO</wicri:noRegion></affiliation></author><author><name sortKey="Strotmeyer, Elsa S" sort="Strotmeyer, Elsa S" uniqKey="Strotmeyer E" first="Elsa S." last="Strotmeyer">Elsa S. Strotmeyer</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="Ensrud, Kristine E" sort="Ensrud, Kristine E" uniqKey="Ensrud K" first="Kristine E." last="Ensrud">Kristine E. Ensrud</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Medicine and Division of Epidemiology & Community Health, University of Minnesota</s1><s2>Minneapolis, MN</s2><s3>USA</s3><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Minneapolis, MN</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Center for Chronic Disease Outcomes Research VA Health Care System</s1><s2>Minneapolis, MN</s2><s3>USA</s3><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Center for Chronic Disease Outcomes Research VA Health Care System</wicri:noRegion></affiliation></author><author><name sortKey="Sellmeyer, Deborah E" sort="Sellmeyer, Deborah E" uniqKey="Sellmeyer D" first="Deborah E." last="Sellmeyer">Deborah E. Sellmeyer</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>School of Medicine, Johns Hopkins University</s1><s2>Baltimore, MD</s2><s3>USA</s3><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Baltimore, MD</wicri:noRegion></affiliation></author><author><name sortKey="Bauer, Douglas C" sort="Bauer, Douglas C" uniqKey="Bauer D" first="Douglas C." last="Bauer">Douglas C. Bauer</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>University of California, San Francisco</s1><s2>San Francisco, CA</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">San Francisco</settlement><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Hoffman, Andrew R" sort="Hoffman, Andrew R" uniqKey="Hoffman A" first="Andrew R." last="Hoffman">Andrew R. Hoffman</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>VA Palo Alto Health Care System</s1><s2>Palo Alto, CA</s2><s3>USA</s3><sZ>6 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>VA Palo Alto Health Care System</wicri:noRegion></affiliation></author><author><name sortKey="Dam, Thuy Tien L" sort="Dam, Thuy Tien L" uniqKey="Dam T" first="Thuy-Tien L." last="Dam">Thuy-Tien L. Dam</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>University of California, San Diego</s1><s2>La Jolla, CA</s2><s3>USA</s3><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">San Diego</settlement><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Barrett Connor, Elizabeth" sort="Barrett Connor, Elizabeth" uniqKey="Barrett Connor E" first="Elizabeth" last="Barrett-Connor">Elizabeth Barrett-Connor</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>University of California, San Diego</s1><s2>La Jolla, CA</s2><s3>USA</s3><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">San Diego</settlement><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Palermo, Lisa" sort="Palermo, Lisa" uniqKey="Palermo L" first="Lisa" last="Palermo">Lisa Palermo</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>University of California, San Francisco</s1><s2>San Francisco, CA</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">San Francisco</settlement><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Orwoll, Eric S" sort="Orwoll, Eric S" uniqKey="Orwoll E" first="Eric S." last="Orwoll">Eric S. Orwoll</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Oregon Health & Science University</s1><s2>Portland, OR</s2><s3>USA</s3><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Oregon Health & Science University</wicri:noRegion></affiliation></author><author><name sortKey="Cummings, Steven R" sort="Cummings, Steven R" uniqKey="Cummings S" first="Steven R." last="Cummings">Steven R. Cummings</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>California Pacific Medical Center</s1><s2>San Francisco, CA</s2><s3>USA</s3><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>California Pacific Medical Center</wicri:noRegion></affiliation></author><author><name sortKey="Black, Dennis M" sort="Black, Dennis M" uniqKey="Black D" first="Dennis M." last="Black">Dennis M. Black</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>University of California, San Francisco</s1><s2>San Francisco, CA</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">San Francisco</settlement><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Schwartz, Ann V" sort="Schwartz, Ann V" uniqKey="Schwartz A" first="Ann V." last="Schwartz">Ann V. Schwartz</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>University of California, San Francisco</s1><s2>San Francisco, CA</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">San Francisco</settlement><region type="state">Californie</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Diabetologia : (Berlin)</title><title level="j" type="abbreviated">Diabetologia : (Berl.)</title><idno type="ISSN">0012-186X</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Diabetologia : (Berlin)</title><title level="j" type="abbreviated">Diabetologia : (Berl.)</title><idno type="ISSN">0012-186X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Bone</term><term>Diabetes mellitus</term><term>Elderly</term><term>Fasting</term><term>Fracture</term><term>Glucose</term><term>Human</term><term>Insulin</term><term>Osteoporosis</term><term>Risk factor</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Fracture</term><term>Facteur risque</term><term>Homme</term><term>Os</term><term>Jeûne alimentaire</term><term>Glucose</term><term>Diabète</term><term>Insuline</term><term>Ostéoporose</term><term>Personne âgée</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term><term>Glucose</term><term>Diabète</term><term>Personne âgée</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Aims/hypothesis Diabetes mellitus is associated with increased fracture risk in women but few studies are available in men. To evaluate the relationship between diabetes and prospective non-vertebral fractures in elderly men, we used data from the Osteoporotic Fractures in Men (MrOS) study. Methods The MrOS enrolled 5,994 men (aged >65 years). Diabetes (ascertained by self-report, the use of medication for diabetes or an elevated fasting glucose level) was reported in 881 individuals, 80 of whom were using insulin. Hip and spine bone mineral density (BMD) was measured using dual x-ray absorptiometry (DXA). After recruitment, the men were followed for incident non-vertebral fractures using a triannual (3 yearly) questionnaire for an average of 9.1 (SD 2.7) years. The Cox proportional hazards model was used to assess the incident risk of fractures. Results In models adjusted for age, race, clinic site and total hip BMD, the risk of non-vertebral fracture was higher in men with diabetes compared with normoglycaemic men (HR 1.30, 95% CI 1.09, 1.54) and was elevated in men using insulin (HR 2.46, 95% CI 1.69, 3.59). Men with impaired fasting glucose did not have a higher risk of fracture compared with normoglycaemic men (HR 1.04, 95% CI 0.89, 1.21). After multivariable adjustment, the risk of non-vertebral fracture remained higher only among men with diabetes who were using insulin (HR 1.74, 95% CI 1.13, 2.69). Conclusions/interpretation Men with diabetes who are using insulin have an increased risk of non-vertebral fracture for a given age and BMD.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Californie</li><li>Pennsylvanie</li></region><settlement><li>Pittsburgh</li><li>San Diego</li><li>San Francisco</li></settlement><orgName><li>Université de Pittsburgh</li></orgName></list><tree><country name="États-Unis"><noRegion><name sortKey="Napoli, Nicola" sort="Napoli, Nicola" uniqKey="Napoli N" first="Nicola" last="Napoli">Nicola Napoli</name></noRegion><name sortKey="Barrett Connor, Elizabeth" sort="Barrett Connor, Elizabeth" uniqKey="Barrett Connor E" first="Elizabeth" last="Barrett-Connor">Elizabeth Barrett-Connor</name><name sortKey="Bauer, Douglas C" sort="Bauer, Douglas C" uniqKey="Bauer D" first="Douglas C." last="Bauer">Douglas C. Bauer</name><name sortKey="Black, Dennis M" sort="Black, Dennis M" uniqKey="Black D" first="Dennis M." last="Black">Dennis M. Black</name><name sortKey="Cummings, Steven R" sort="Cummings, Steven R" uniqKey="Cummings S" first="Steven R." last="Cummings">Steven R. Cummings</name><name sortKey="Dam, Thuy Tien L" sort="Dam, Thuy Tien L" uniqKey="Dam T" first="Thuy-Tien L." last="Dam">Thuy-Tien L. Dam</name><name sortKey="Ensrud, Kristine E" sort="Ensrud, Kristine E" uniqKey="Ensrud K" first="Kristine E." last="Ensrud">Kristine E. Ensrud</name><name sortKey="Ensrud, Kristine E" sort="Ensrud, Kristine E" uniqKey="Ensrud K" first="Kristine E." last="Ensrud">Kristine E. Ensrud</name><name sortKey="Hoffman, Andrew R" sort="Hoffman, Andrew R" uniqKey="Hoffman A" first="Andrew R." last="Hoffman">Andrew R. Hoffman</name><name sortKey="Orwoll, Eric S" sort="Orwoll, Eric S" uniqKey="Orwoll E" first="Eric S." last="Orwoll">Eric S. Orwoll</name><name sortKey="Palermo, Lisa" sort="Palermo, Lisa" uniqKey="Palermo L" first="Lisa" last="Palermo">Lisa Palermo</name><name sortKey="Schwartz, Ann V" sort="Schwartz, Ann V" uniqKey="Schwartz A" first="Ann V." last="Schwartz">Ann V. Schwartz</name><name sortKey="Sellmeyer, Deborah E" sort="Sellmeyer, Deborah E" uniqKey="Sellmeyer D" first="Deborah E." last="Sellmeyer">Deborah E. Sellmeyer</name><name sortKey="Strotmeyer, Elsa S" sort="Strotmeyer, Elsa S" uniqKey="Strotmeyer E" first="Elsa S." last="Strotmeyer">Elsa S. Strotmeyer</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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