Visit-to-visit variation of fasting plasma glucose is a predictor of hip fracture in older persons with type 2 diabetes: the Taiwan Diabetes Study
Tóm tắt
We investigated the association between fasting plasma glucose variability (FPG-CV) and the risk of hip fracture in elderly diabetic patients. Our finding showed a temporal association between FPG-CV and hip fracture as patients categorized as FPG-CV greater than 25.4 % showed an increased risk in hip fractures. Hip fracture is a major health burden in the population and is associated with high rates of mortality and morbidity especially in elderly. It is evident that diabetes mellitus is a risk factor of osteoporosis which is a significant risk factor of hip fracture. However, epidemiological studies exploring the risks of hip fracture among type 2 diabetic patients are limited. A retrospective study of 26,501 ethnic Chinese older persons enrolled in the National Diabetes Care Management program in Taiwan was conducted; related factors were analyzed with extended Cox proportional hazards regression models to competing risk data on hip fracture incidence. The results show a temporal association between FPG-CV and hip fracture as patients categorized as FPG-CV greater than 25.4 % showed an increased risk in hip fractures, confirming a linear relationship between the two. After multivariate adjustment, the risk of hip fracture increased among patients with FPG-CV of 25.4–42.3 % and >42.3 % compared with patients with FPG-CV of ≦ 14.3 % (hazard ratio, 1.35; 95 % confidence interval 1.14–1.60 and 1.27; 1.07–1.52, respectively). Significant linear trends among various FPG-CV were observed. Thus, the present study demonstrated the importance of glucose stability for fracture prevention in older persons with type 2 diabetes. Future studies should be conducted to explore whether reduction in glucose oscillation in older adults with diabetes mellitus can reduce the risk of hip fracture.
Tài liệu tham khảo
Strom O, Borgstrom F, Kanis JA, Compston J, Cooper C, McCloskey EV, Jonsson B (2011) Osteoporosis: burden, health care provision and opportunities in the EU: a report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 6:59–155
Robbins J, Aragaki AK, Kooperberg C et al (2007) Factors associated with 5-year risk of hip fracture in postmenopausal women. Jama 298:2389–2398
Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B, Oglesby AK (2003) The components of excess mortality after hip fracture. Bone 32:468–473
Janghorbani M, Feskanich D, Willett WC, Hu F (2006) Prospective study of diabetes and risk of hip fracture: the Nurses’ Health Study. Diabetes Care 29:1573–1578
Fan Y, Wei F, Lang Y, Liu Y (2016) Diabetes mellitus and risk of hip fractures: a meta-analysis. Osteoporosis Int J Established Result Cooperation Between Eur Found Osteoporosis Nation Osteoporosis Found USA 27:219–228
Ma L, Oei L, Jiang L, Estrada K, Chen H, Wang Z, Yu Q, Zillikens MC, Gao X, Rivadeneira F (2012) Association between bone mineral density and type 2 diabetes mellitus: a meta-analysis of observational studies. Eur J Epidemiol 27:319–332
Ceriello A, Ihnat MA (2010) ’Glycaemic variability’: a new therapeutic challenge in diabetes and the critical care setting. Diabetic Med J British Diabetic Assoc 27:862–867
Ceriello A, Esposito K, Piconi L, Ihnat MA, Thorpe JE, Testa R, Boemi M, Giugliano D (2008) Oscillating glucose is more deleterious to endothelial function and oxidative stress than mean glucose in normal and type 2 diabetic patients. Diabetes 57:1349–1354
Quagliaro L, Piconi L, Assaloni R, Martinelli L, Motz E, Ceriello A (2003) Intermittent high glucose enhances apoptosis related to oxidative stress in human umbilical vein endothelial cells: the role of protein kinase C and NAD(P)H-oxidase activation. Diabetes 52:2795–2804
Ihnat MAKR, Thorpe JE, Green DE, Kamat CD (2007) Attenuated superoxide dismutase induction in retinal cells in response to intermittent high versus continuous high glucose. Am J Biochem Biotechol 3:16–23
Wu VC, Huang TM, Wu PC et al (2012) Preoperative proteinuria is associated with long-term progression to chronic dialysis and mortality after coronary artery bypass grafting surgery. PLoS One 7:e27687
12. National Health Insurance Administration MoHaW (2010) The National Health Insurance Statistics, 2010. http://www.nhi.gov.tw/English/webdata/webdata.aspx?menu=11&menu_id=296&WD_ID=296&webdata_id=4010
Kilpatrick ES, Rigby AS, Atkin SL (2008) A1C variability and the risk of microvascular complications in type 1 diabetes: data from the Diabetes Control and Complications Trial. Diabetes Care 31:2198–2202
Lunn M, McNeil D (1995) Applying Cox regression to competing risks. Biometrics 51:524–532
Nalysnyk L, Hernandez-Medina M, Krishnarajah G (2010) Glycaemic variability and complications in patients with diabetes mellitus: evidence from a systematic review of the literature. Diabetes Obes Metab 12:288–298
Lin CC, Li CI, Yang SY, Liu CS, Chen CC, Fuh MM, Chen W, Li TC (2012) Variation of fasting plasma glucose: a predictor of mortality in patients with type 2 diabetes. Am J Med 125(416):e419–418
Lin CC, Yang CP, Li CI, Liu CS, Chen CC, Lin WY, Hwang KL, Yang SY, Li TC (2014) Visit-to-visit variability of fasting plasma glucose as predictor of ischemic stroke: competing risk analysis in a national cohort of Taiwan Diabetes Study. BMC Med 12:165
Cheng D, Fei Y, Liu Y, Li J, Xue Q, Wang X, Wang N (2014) HbA1C variability and the risk of renal status progression in Diabetes Mellitus: a meta-analysis. PLoS One 9:e115509
Puar TH, Khoo JJ, Cho LW, Xu Y, Chen YT, Chuo AM, Poh CB, Ng JM (2012) Association between glycemic control and hip fracture. J Am Geriatr Soc 60:1493–1497
Schwartz AV, Margolis KL, Sellmeyer DE et al (2012) Intensive glycemic control is not associated with fractures or falls in the ACCORD randomized trial. Diabetes Care 35:1525–1531
Schneider AL, Williams EK, Brancati FL, Blecker S, Coresh J, Selvin E (2013) Diabetes and risk of fracture-related hospitalization: the Atherosclerosis Risk in Communities Study. Diabetes Care 36:1153–1158
Oei L, Zillikens MC, Dehghan A et al (2013) High bone mineral density and fracture risk in type 2 diabetes as skeletal complications of inadequate glucose control: the Rotterdam Study. Diabetes Care 36:1619–1628
Shu A, Yin MT, Stein E, Cremers S, Dworakowski E, Ives R, Rubin MR (2012) Bone structure and turnover in type 2 diabetes mellitus. Osteoporosis Int J Established Result Cooperation Between Eur Foundation Osteoporosis and National Osteoporosis Found USA 23:635–641
Dobnig H, Piswanger-Solkner JC, Roth M, Obermayer-Pietsch B, Tiran A, Strele A, Maier E, Maritschnegg P, Sieberer C, Fahrleitner-Pammer A (2006) Type 2 diabetes mellitus in nursing home patients: effects on bone turnover, bone mass, and fracture risk. J Clin Endocrinol Metab 91:3355–3363
Alikhani M, Alikhani Z, Boyd C, MacLellan CM, Raptis M, Liu R, Pischon N, Trackman PC, Gerstenfeld L, Graves DT (2007) Advanced glycation end products stimulate osteoblast apoptosis via the MAP kinase and cytosolic apoptotic pathways. Bone 40:345–353
Paul RG, Bailey AJ (1996) Glycation of collagen: the basis of its central role in the late complications of ageing and diabetes. Int J Biochem Cell Biol 28:1297–1310
Vashishth D, Gibson GJ, Khoury JI, Schaffler MB, Kimura J, Fyhrie DP (2001) Influence of nonenzymatic glycation on biomechanical properties of cortical bone. Bone 28:195–201
Chailurkit LO, Chanprasertyothin S, Rajatanavin R, Ongphiphadhanakul B (2008) Reduced attenuation of bone resorption after oral glucose in type 2 diabetes. Clin Endocrinol 68:858–862
Li CI, Liu CS, Lin WY, Meng NH, Chen CC, Yang SY, Chen HJ, Lin CC, Li TC (2015) Glycated hemoglobin level and risk of hip fracture in older people with type 2 diabetes: a competing risk analysis of Taiwan Diabetes Cohort Study. J Bone Mineral Res Off J Am Soc Bone Mineral Res 30:1338–1346
Garcia-Hernandez A, Arzate H, Gil-Chavarria I, Rojo R, Moreno-Fierros L (2012) High glucose concentrations alter the biomineralization process in human osteoblastic cells. Bone 50:276–288
De L II, Van Der Klift M, De Laet CE, Van Daele PL, Hofman A, Pols HA (2005) Bone mineral density and fracture risk in type-2 diabetes mellitus: the Rotterdam Study. Osteoporosis international. J Established Result Cooperation Between Eur Found Osteoporosis Nation Osteoporosis Found USA 16:1713–1720
Christiansen C, Christensen MS, McNair P, Nielsen B, Madsbad S (1982) Vitamin D metabolites in diabetic patients: decreased serum concentration of 24,25-dihydroxyvitamin D. Scand J Clin Lab Invest 42:487–491
Nyomba BL, Verhaeghe J, Thomasset M, Lissens W, Bouillon R (1989) Bone mineral homeostasis in spontaneously diabetic BB rats. I. Abnormal vitamin D metabolism and impaired active intestinal calcium absorption. Endocrinology 124:565–572
Balint E, Szabo P, Marshall CF, Sprague SM (2001) Glucose-induced inhibition of in vitro bone mineralization. Bone 28:21–28
Lips P (2001) Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 22:477–501
Schwartz AV, Sellmeyer DE, Ensrud KE, Cauley JA, Tabor HK, Schreiner PJ, Jamal SA, Black DM, Cummings SR (2001) Study of Osteoporotic Features Research G (2001) Older women with diabetes have an increased risk of fracture: a prospective study. J Clin Endocrinol Metab 86:32–38
Ivers RQ, Cumming RG, Mitchell P, Peduto AJ, Blue Mountains Eye S (2001) Diabetes and risk of fracture: The Blue Mountains Eye Study. Diabetes Care 24:1198–1203
Roman de Mettelinge T, Cambier D, Calders P, Van Den Noortgate N, Delbaere K (2013) Understanding the relationship between type 2 diabetes mellitus and falls in older adults: a prospective cohort study. PLoS One 8:e67055
Macgilchrist C, Paul L, Ellis BM, Howe TE, Kennon B, Godwin J (2010) Lower-limb risk factors for falls in people with diabetes mellitus. Diabet Med 27:162–168
Pijpers E, Ferreira I, de Jongh RT, Deeg DJ, Lips P, Stehouwer CD, Nieuwenhuijzen Kruseman AC (2012) Older individuals with diabetes have an increased risk of recurrent falls: analysis of potential mediating factors: the Longitudinal Ageing Study Amsterdam. Age Ageing 41:358–365
de Waard EA, van Geel TA, Savelberg HH, Koster A, Geusens PP, van den Bergh JP (2014) Increased fracture risk in patients with type 2 diabetes mellitus: an overview of the underlying mechanisms and the usefulness of imaging modalities and fracture risk assessment tools. Maturitas 79:265–274
Callaly EL, Ni Chroinin D, Hannon N et al (2015) Falls and fractures 2 years after acute stroke: the North Dublin Population Stroke Study. Age Ageing 44:882–886
Ceriello A, Novials A, Ortega E, La Sala L, Pujadas G, Testa R, Bonfigli AR, Esposito K, Giugliano D (2012) Evidence that hyperglycemia after recovery from hypoglycemia worsens endothelial function and increases oxidative stress and inflammation in healthy control subjects and subjects with type 1 diabetes. Diabetes 61:2993–2997
Mody N, Parhami F, Sarafian TA, Demer LL (2001) Oxidative stress modulates osteoblastic differentiation of vascular and bone cells. Free Radic Biol Med 31:509–519
Garrett IR, Boyce BF, Oreffo RO, Bonewald L, Poser J, Mundy GR (1990) Oxygen-derived free radicals stimulate osteoclastic bone resorption in rodent bone in vitro and in vivo. J Clin Invest 85:632–639
Basu S, Michaelsson K, Olofsson H, Johansson S, Melhus H (2001) Association between oxidative stress and bone mineral density. Biochem Biophys Res Commun 288:275–279