PMID- 25576672
OWN - NLM
STAT- MEDLINE
DCOM- 20160922
LR  - 20221207
IS  - 1873-2763 (Electronic)
IS  - 8756-3282 (Print)
IS  - 1873-2763 (Linking)
VI  - 82
DP  - 2016 Jan
TI  - Diabetes and fracture risk in older U.S. adults.
PG  - 9-15
LID - S8756-3282(14)00460-8 [pii]
LID - 10.1016/j.bone.2014.12.008 [doi]
AB  - OBJECTIVE: We examined the diabetes-fracture relationship by race/ethnicity, 
      including the link between pre-diabetes and fracture. RESEARCH DESIGN AND 
      METHODS: We used Medicare- and mortality-linked data for respondents aged 65years 
      and older from the third National Health and Nutrition Examination Survey (NHANES 
      III) and NHANES 1999-2004 for three race/ethnic groups: non-Hispanic whites 
      (NHW), non-Hispanic blacks (NHB), and Mexican Americans (MA). Diabetes was 
      defined as diagnosed diabetes (self-reported) and diabetes status: diagnosed and 
      undiagnosed diabetes (positive diagnosis or hemoglobin A1c (A1C)>/=6.5%); 
      pre-diabetes (no diagnosis and A1C between 5.7% and 6.4%); and no diabetes (no 
      diagnosis and A1C<5.7%). Non-skull fractures (n=750) were defined using published 
      algorithms. Hazards ratios (HRs) were calculated using Cox proportional hazards 
      models. RESULTS: The diabetes-fracture relationship differed significantly by 
      race/ethnicity (pinteraction<0.05). Compared to those without diagnosed diabetes, 
      the HRs for those with diagnosed diabetes were 2.37 (95% CI 1.49-3.75), 1.87 (95% 
      CI 1.02-3.40), and 1.22 (95% CI 0.93-1.61) for MA, NHB, and NHW, respectively, 
      after adjusting for significant confounders. HRs for diagnosed and undiagnosed 
      diabetes were similar to those for diagnosed diabetes alone. Pre-diabetes was not 
      significantly related to fracture risk, however. Compared to those without 
      diabetes, adjusted HRs for those with pre-diabetes were 1.42 (95% CI 0.72-2.81), 
      and 1.20 (95% CI 0.96-1.51) for MA and NHW, respectively. There were insufficient 
      fracture cases to examine detailed diabetes status in NHB. CONCLUSIONS: The 
      diabetes-fracture relationship was stronger in MA and NHB. Pre-diabetes was not 
      significantly associated with higher fracture risk, however.
CI  - Published by Elsevier Inc.
FAU - Looker, Anne C
AU  - Looker AC
AD  - National Center for Health Statistics, Centers for Disease Control and 
      Prevention, Hyattsville, MD, USA. Electronic address: ALooker@cdc.gov.
FAU - Eberhardt, Mark S
AU  - Eberhardt MS
AD  - National Center for Health Statistics, Centers for Disease Control and 
      Prevention, Hyattsville, MD, USA.
FAU - Saydah, Sharon H
AU  - Saydah SH
AD  - National Center for Chronic Disease Prevention and Health Promotion, Centers for 
      Disease Control and Prevention, Atlanta, GA, USA.
LA  - eng
GR  - CC999999/Intramural CDC HHS/United States
PT  - Journal Article
DEP - 20150107
PL  - United States
TA  - Bone
JT  - Bone
JID - 8504048
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Black People/*ethnology
MH  - Diabetes Mellitus/diagnosis/*ethnology
MH  - Female
MH  - Follow-Up Studies
MH  - Fractures, Bone/diagnosis/*ethnology
MH  - Humans
MH  - Male
MH  - Medicare/trends
MH  - Mexican Americans/*ethnology
MH  - *Nutrition Surveys/trends
MH  - Risk Factors
MH  - United States/epidemiology
MH  - White People/*ethnology
PMC - PMC4757906
MID - NIHMS758513
OID - NLM: HHSPA758513 [Available on 01/01/17]
OTO - NOTNLM
OT  - Diabetes
OT  - Fracture
OT  - Hemoglobin A1c
OT  - NHANES
EDAT- 2015/01/13 06:00
MHDA- 2016/09/23 06:00
PMCR- 2017/01/01
CRDT- 2015/01/11 06:00
PHST- 2014/11/13 00:00 [received]
PHST- 2014/12/09 00:00 [revised]
PHST- 2014/12/12 00:00 [accepted]
PHST- 2015/01/11 06:00 [entrez]
PHST- 2015/01/13 06:00 [pubmed]
PHST- 2016/09/23 06:00 [medline]
PHST- 2017/01/01 00:00 [pmc-release]
AID - S8756-3282(14)00460-8 [pii]
AID - 10.1016/j.bone.2014.12.008 [doi]
PST - ppublish
SO  - Bone. 2016 Jan;82:9-15. doi: 10.1016/j.bone.2014.12.008. Epub 2015 Jan 7.