Risk of fracture in women with type 2 diabetes: The women's health initiative observational study

Denise E. Bonds, Joseph C. Larson, Ann V. Schwartz, Elsa S. Strotmeyer, John A Robbins, Beatriz L. Rodriguez, Karen C. Johnson, Karen L. Margolis

Research output: Contribution to journalArticle

337 Citations (Scopus)

Abstract

Context: Some but not all studies have shown higher rates of fracture in individuals with type 2 diabetes. Objective: The objective of the study was to determine the risk of fracture in postmenopausal women with type 2 diabetes and determine whether risk varies by fracture site, ethnicity, and baseline bone density. Design, Setting, and Participants: Women with clinically diagnosed type 2 diabetes at baseline in the Women's Health Initiative Observational Cohort, a prospective study of postmenopausal women (n = 93,676), were compared with women without diagnosed diabetes and risk of fracture overall and at specific sites determined. Main Outcome Measures: All fractures and specific sites separately (hip/pelvis/upper leg; lower leg/ankle/knee; foot; upper arm/shoulder/elbow; lower arm/wrist/hand; spine/tailbone) were measured. Bone mineral density (BMD) in a subset also was measured. Results: The overall risk of fracture after 7 yr of follow-up was higher in women with diabetes at baseline after controlling for multiple risk factors including frequency of falls [adjusted relative risk (RR) 1.20, 95% confidence interval (CI) 1.11-1.30]. In a subsample of women with baseline BMD scores, women with diabetes had greater hip and spine BMD. The elevated fracture risk was found at multiple sites (hip/pelvis/upper leg; foot; spine/tailbone) among black women (RR 1.33, 95% CI 1.00-1.75) and women with increased baseline bone density (RR 1.26, 95% CI 0.96-1.66). Conclusion: Women with type 2 diabetes are at increased risk for fractures. This risk is also seen among black and non-Hispanic white women after adjustment for multiple risk factors including frequent falls and increased BMD (in a subset).

Original languageEnglish (US)
Pages (from-to)3404-3410
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Volume91
Issue number9
DOIs
StatePublished - 2006

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Women's Health
Medical problems
Type 2 Diabetes Mellitus
Observational Studies
Bone Density
Bone
Minerals
Leg
Spine
Confidence Intervals
Pelvis
Hip
Foot
Arm
Pelvic Bones
Elbow
Wrist
Ankle
Set theory
Knee

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Bonds, D. E., Larson, J. C., Schwartz, A. V., Strotmeyer, E. S., Robbins, J. A., Rodriguez, B. L., ... Margolis, K. L. (2006). Risk of fracture in women with type 2 diabetes: The women's health initiative observational study. Journal of Clinical Endocrinology and Metabolism, 91(9), 3404-3410. https://doi.org/10.1210/jc.2006-0614

Risk of fracture in women with type 2 diabetes : The women's health initiative observational study. / Bonds, Denise E.; Larson, Joseph C.; Schwartz, Ann V.; Strotmeyer, Elsa S.; Robbins, John A; Rodriguez, Beatriz L.; Johnson, Karen C.; Margolis, Karen L.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 91, No. 9, 2006, p. 3404-3410.

Research output: Contribution to journalArticle

Bonds, DE, Larson, JC, Schwartz, AV, Strotmeyer, ES, Robbins, JA, Rodriguez, BL, Johnson, KC & Margolis, KL 2006, 'Risk of fracture in women with type 2 diabetes: The women's health initiative observational study', Journal of Clinical Endocrinology and Metabolism, vol. 91, no. 9, pp. 3404-3410. https://doi.org/10.1210/jc.2006-0614
Bonds, Denise E. ; Larson, Joseph C. ; Schwartz, Ann V. ; Strotmeyer, Elsa S. ; Robbins, John A ; Rodriguez, Beatriz L. ; Johnson, Karen C. ; Margolis, Karen L. / Risk of fracture in women with type 2 diabetes : The women's health initiative observational study. In: Journal of Clinical Endocrinology and Metabolism. 2006 ; Vol. 91, No. 9. pp. 3404-3410.
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AU - Rodriguez, Beatriz L.

AU - Johnson, Karen C.

AU - Margolis, Karen L.

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N2 - Context: Some but not all studies have shown higher rates of fracture in individuals with type 2 diabetes. Objective: The objective of the study was to determine the risk of fracture in postmenopausal women with type 2 diabetes and determine whether risk varies by fracture site, ethnicity, and baseline bone density. Design, Setting, and Participants: Women with clinically diagnosed type 2 diabetes at baseline in the Women's Health Initiative Observational Cohort, a prospective study of postmenopausal women (n = 93,676), were compared with women without diagnosed diabetes and risk of fracture overall and at specific sites determined. Main Outcome Measures: All fractures and specific sites separately (hip/pelvis/upper leg; lower leg/ankle/knee; foot; upper arm/shoulder/elbow; lower arm/wrist/hand; spine/tailbone) were measured. Bone mineral density (BMD) in a subset also was measured. Results: The overall risk of fracture after 7 yr of follow-up was higher in women with diabetes at baseline after controlling for multiple risk factors including frequency of falls [adjusted relative risk (RR) 1.20, 95% confidence interval (CI) 1.11-1.30]. In a subsample of women with baseline BMD scores, women with diabetes had greater hip and spine BMD. The elevated fracture risk was found at multiple sites (hip/pelvis/upper leg; foot; spine/tailbone) among black women (RR 1.33, 95% CI 1.00-1.75) and women with increased baseline bone density (RR 1.26, 95% CI 0.96-1.66). Conclusion: Women with type 2 diabetes are at increased risk for fractures. This risk is also seen among black and non-Hispanic white women after adjustment for multiple risk factors including frequent falls and increased BMD (in a subset).

AB - Context: Some but not all studies have shown higher rates of fracture in individuals with type 2 diabetes. Objective: The objective of the study was to determine the risk of fracture in postmenopausal women with type 2 diabetes and determine whether risk varies by fracture site, ethnicity, and baseline bone density. Design, Setting, and Participants: Women with clinically diagnosed type 2 diabetes at baseline in the Women's Health Initiative Observational Cohort, a prospective study of postmenopausal women (n = 93,676), were compared with women without diagnosed diabetes and risk of fracture overall and at specific sites determined. Main Outcome Measures: All fractures and specific sites separately (hip/pelvis/upper leg; lower leg/ankle/knee; foot; upper arm/shoulder/elbow; lower arm/wrist/hand; spine/tailbone) were measured. Bone mineral density (BMD) in a subset also was measured. Results: The overall risk of fracture after 7 yr of follow-up was higher in women with diabetes at baseline after controlling for multiple risk factors including frequency of falls [adjusted relative risk (RR) 1.20, 95% confidence interval (CI) 1.11-1.30]. In a subsample of women with baseline BMD scores, women with diabetes had greater hip and spine BMD. The elevated fracture risk was found at multiple sites (hip/pelvis/upper leg; foot; spine/tailbone) among black women (RR 1.33, 95% CI 1.00-1.75) and women with increased baseline bone density (RR 1.26, 95% CI 0.96-1.66). Conclusion: Women with type 2 diabetes are at increased risk for fractures. This risk is also seen among black and non-Hispanic white women after adjustment for multiple risk factors including frequent falls and increased BMD (in a subset).

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