Osteoporotic fractures are a significant health issue and create a heavy economic burden. Initial studies suggest that diabetes mellitus (DM) could be a risk factor for increased fractures. One of the main mechanisms could be modulation of osteoblastic gene expression by chronic hyperglycemia. The purpose of this study was to assess the association of hemoglobin A1c levels with non‐traumatic fractures in the hospital setting.
This was a retrospective case‐control study of patients with osteoporosis and DM. Patients were defined as cases – subjects who had a non‐traumatic fracture, and controls – subjects who did not have a non‐traumatic fracture. Out of patients admitted to GSH during 2008‐2012 with a history of osteoporosis and DM, 59 cases were identified. The study was designed to determine if patients who experienced a non‐traumatic fracture were more likely to have a higher HbA1c than patients who did not experience a non‐traumatic fracture. Patients were stratified into two groups: HbA1c >7.5 and HbA1c <7.5. Univariate analysis, including chi‐square and t‐test, and multivariate analysis were conducted. All analyses were done using SPSS 21.0.
Out of 219 patients, the major fracture risk factors of current smoker and low body weight (BMI <18.5), were respectively reported as follows: 11 % (23/216) and 5% (10/216). In terms of fracture protective factors, calcium intake was evident in 41% (88/213) of patients, vitamin D in 33% (71/213), and osteoporosis medications in 28% (59/212). Univariate analysis showed white race and elevated HbA1c (>7.5) to be associated with non‐traumatic fractures. Multivariate analysis revealed that elevated HbA1c remained as a significant risk factor for non‐traumatic fractures (OR=2.3; 95% CI=1.18 — 4.52).
Elevated HbA1c increases the risk of non‐traumatic fractures in hospitalized patients with osteoporosis and DM.
To cite this abstract:Shodunke T, Wang Z, Louis M, Steinbrunner J. Association of Hemoglobin A1C and Non‐Traumatic Osteoporotic Fractures in Diabetic Patients. Abstract published at Hospital Medicine 2014, March 24-27, Las Vegas, Nev. Abstract 72. Journal of Hospital Medicine. 2014; 9 (suppl 2). https://www.shmabstracts.com/abstract/association-of-hemoglobin-a1c-and-nontraumatic-osteoporotic-fractures-in-diabetic-patients/. Accessed June 19, 2019.