Associations Among Disease Conditions, Bone Mineral Density, and Prevalent Vertebral Deformities in Men and Women 50 Years of Age and Older: Cross-Sectional Results From the Canadian Multicentre Osteoporosis Study

Hanley, D.A.; Brown, Jacques P.; Tenenhouse, Alan; Olszynski, W. P.; Ioannidis, George; Berger, Claudie; Prior, J. C.; Pickard, Laura; Tm, Murray; Anastassiades, Tassos; Kirkland, Susan; Joyce, Carol; Joseph, Lawrence; Παπαϊωάννου, Αλεξάνδρα; Jackson, S. A.; Poliquin, Suzette; Adachi, J.D.

doi:10.1359/jbmr.2003.18.4.784

Cited by 152 publications

(92 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…(16,18,20) Our data are in agreement with those from the Canadian Multicentre Osteoporosis Study, which found no evidence of an increase in the prevalence of vertebral fractures in T2DM men aged 50 years and older (adjusted OR, 0.77; 95% CI, 0.49 to 1.22). (16) Another group reported that the presence of T2DM was an independent risk factor for prevalent VFs in Japanese men aged 50 years and older (OR, 4.73; 95% CI, 2.19 to 10.2) after adjusting for age, BMI, and lumbar spine BMD. (20) Because VFs are a major cause of pain and disability, (36,37) it is important to identify subjects at increased risk of VFs.…”

Section: Discussionsupporting

confidence: 89%

See 1 more Smart Citation

Vertebral Fracture Risk in Diabetic Elderly Men: The MrOS Study

Napoli

Schwartz²,

Schafer

et al. 2017

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

Type 2 diabetes (T2DM) is associated with a significant increase in risk of nonvertebral fractures, but information on risk of vertebral fractures (VFs) in subjects with T2DM, particularly among men, is lacking. Furthermore, it is not known whether spine bone mineral density (BMD) can predict the risk of VF in T2DM. We sought to examine the effect of diabetes status on prevalent and incident vertebral fracture, and to estimate the effect of lumbar spine BMD (areal and volumetric) as a risk factor for prevalent and incident morphometric vertebral fracture in T2DM (n ¼ 875) and nondiabetic men (n ¼ 4679). We used data from the Osteoporotic Fractures in Men (MrOS) Study, which enrolled men aged !65 years. Lumbar spine areal BMD (aBMD) was measured with dual-energy X-ray absorptiometry (DXA), and volumetric BMD (vBMD) by quantitative computed tomography (QCT). Prevalence (7.0% versus 7.7%) and incidence (4.4% versus 4.5%) of VFs were not higher in T2DM versus nondiabetic men. The risk of prevalent (OR, 1.05; 95% CI, 0.78 to 1.40) or incident vertebral-fracture (OR, 1.28; 95% CI, 0.81 to 2.00) was not higher in T2DM versus nondiabetic men in models adjusted for age, clinic site, race, BMI, and aBMD. Higher spine aBMD was associated with lower risk of prevalent VF in T2DM (OR, 0.55; 95% CI, 0.48 to 0.63) and nondiabetic men (OR, 0.66; 95% CI, 0.5 to 0.88) (p for interaction ¼ 0.24) and of incident VF in T2DM (OR, 0.50; 95% CI, 0.41 to 0.60) and nondiabetic men (OR, 0.54; 95% CI, 0.33 to 0.88) (p for interaction ¼ 0.77). Results were similar for vBMD. In conclusion, T2DM was not associated with higher prevalent or incident VF in older men, even after adjustment for BMI and BMD. Higher spine aBMD and vBMD are associated with lower prevalence and incidence of VF in T2DM as well as nondiabetic men.

show abstract

Section: Discussionsupporting

confidence: 89%

“…(6,15,16) To date, information on VF risk in T2DM men is very limited and conflicting, and mostly based on prevalent VFs. (16)(17)(18)(19)(20) Thus, it is still not clear whether VF risk is increased in men with T2DM.…”

Section: Introductionmentioning

confidence: 99%

Vertebral Fracture Risk in Diabetic Elderly Men: The MrOS Study

Napoli

Schwartz²,

Schafer

et al. 2017

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

show abstract

“…Although adjustment for adiposity weakened the association, it did not remove it completely. The main strength of this study, and an advance over previous studies [6,7] was the measurement of insulin levels in the cohort; hyperinsulinaemia can affect BMD both directly and indirectly (acting through BMI), and our results would support the latter hypothesis.…”

Section: Discussionsupporting

confidence: 56%

“…A recent cross-sectional study of over 7500 Canadian men and women showed that type 2 diabetes was associated with higher bone mineral density (BMD) even after adjustment for confounding variables, although relationships were stronger in women [7]. The authors speculated that these findings might be due to an anabolic effect of insulin on bone tissue, as type 2 diabetes may be preceded by a period of insulin resistance leading to hyperinsulinaemia.…”

Section: Introductionmentioning

confidence: 99%

Type 2 diabetes mellitus is associated with increased axial bone density in men and women from the Hertfordshire Cohort Study: evidence for an indirect effect of insulin resistance?

et al. 2004

View full text Add to dashboard Cite

Aims/hypothesis. Previous studies have suggested that the high bone density often observed in type 2 diabetic patients may be explained by insulin resistance. We explored this hypothesis in the Hertfordshire Cohort Study. Methods. A total of 465 men and 444 women aged 59 to 71 years and with no prior diagnosis of diabetes attended a clinic where a glucose tolerance test was performed and bone density measured at the femoral neck and lumbar spine. Biochemical markers of bone turnover (serum osteocalcin and urinary mean c-terminal cross-linking telopeptide of type II collagen) were measured in 163 men. Results. According to WHO criteria, 83 men and 134 women were diagnosed with impaired glucose tolerance and a further 33 men and 32 women were diagnosed as having type 2 diabetes. Bone density was higher in newly diagnosed diabetic subjects, with relationships stronger in women (p<0.001) than men (p<0.05) and attenuated by adjustment for body mass index. In both sexes, we observed positive correlations between the total femur and femoral neck bone mineral density with measures of insulin resistance (r=0.17-0.22), with stronger results observed in women. These relationships did not apply after adjustment for body mass index. Glucose status did not lead to differences in osteocalcin level or c-terminal cross-linking telopeptide of type II collagen levels. Conclusions/interpretation. Our findings suggest that hyperinsulinaemia may affect bone mineral density through indirect effects, e.g. body weight.Keywords Bone density · Diabetes · Insulin

show abstract

“…The association between low bone mineral density (BMD) and diabetes has most consistently been observed in type 1 patients [4,5], with increased bone mineral loss attributed to early age at diagnosis, long duration, prolonged poor glycaemic control and high insulin doses [6][7][8][9]. In type 2 diabetes, the relationship is less clear, with reports of increased [10], decreased [11] or unchanged [12] bone mass and BMD, probably reflecting the heterogeneity of the disease and/or the different study methodologies used.…”

Section: Introductionmentioning

confidence: 99%

Bone mineral density and its determinants in diabetes: the Fremantle Diabetes Study

et al. 2006

View full text Add to dashboard Cite

Aims/hypothesis: We assessed the effects of type 1 and type 2 diabetes on bone density and metabolism.Materials and methods: We analysed bone mineral density (BMD) measured at the hip, spine and forearm using dual energy X-ray absorptiometry in 34 patients with type 1 and 194 patients with type 2 diabetes. Patients were from the community-based Fremantle Diabetes Study, and findings for them were compared with those from normal age-and sex-matched control subjects from the local community. Biochemical and hormonal markers of bone metabolism were measured in a subset of 70 patients. Results: After adjusting for age and BMI, there was a lower BMD at total hip (p<0.001) and femoral neck (p=0.012) in type 1 men vs control subjects, but type 1 women and matched controls had similar BMD at each site. There was a higher BMD at total hip (p=0.006), femoral neck (p=0.026) and forearm (p<0.001) in type 2 women vs control subjects, but diabetes status was not associated with BMD in type 2 men after adjustment for age and BMI. Serum oestradiol, BMI, C-terminal telopeptide of collagen type 1 and male sex were consistently and independently associated with BMD at forearm, hip and femoral neck and explained 61, 55 and 50% of the total variance in BMD, respectively, at these sites. Spine BMD was independently associated with BMI and ln(oestradiol). Conclusions/interpretation: Men with type 1 diabetes may be at increased risk of osteoporosis, while type 2 women appear to be protected even after adjusting for BMI. Low serum oestradiol concentrations may predispose to diabetes-associated osteoporosis regardless of sex.

show abstract

Associations Among Disease Conditions, Bone Mineral Density, and Prevalent Vertebral Deformities in Men and Women 50 Years of Age and Older: Cross-Sectional Results From the Canadian Multicentre Osteoporosis Study

Cited by 152 publications

References 25 publications

Vertebral Fracture Risk in Diabetic Elderly Men: The MrOS Study

Vertebral Fracture Risk in Diabetic Elderly Men: The MrOS Study

Type 2 diabetes mellitus is associated with increased axial bone density in men and women from the Hertfordshire Cohort Study: evidence for an indirect effect of insulin resistance?

Bone mineral density and its determinants in diabetes: the Fremantle Diabetes Study

Contact Info

Product

Resources

About