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Current Gerontology and Geriatrics Research
Volume 2011, Article ID 979270, 8 pages
Clinical Study

Potential Explanatory Factors for Higher Incident Hip Fracture Risk in Older Diabetic Adults

1Department of Epidemiology, Center for Aging and Population Health, University of Pittsburgh, 130 North Bellefield Avenue, Room 515, Pittsburgh, PA 15213, USA
2Group Health Research Institute, Seattle, WA 98101-2900, USA
3Department of Medicine, University of California, Davis, CA 95817, USA
4VA Pittsburgh Healthcare System and Renal-Electrolyte Division, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15240, USA
5The Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology, University of Washington, Seattle, WA 98101, USA
6Laboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, MD 20892, USA
7Division of Geriatric Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA

Received 23 December 2010; Revised 22 March 2011; Accepted 24 May 2011

Academic Editor: Richard Crilly

Copyright © 2011 Elsa S. Strotmeyer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Type 2 diabetes is associated with higher fracture risk. Diabetes-related conditions may account for this risk. Cardiovascular Health Study participants (N=5641; 42.0% men; 15.5% black; 72.8±5.6 years) were followed 10.9 ± 4.6 years. Diabetes was defined as hypoglycemic medication use or fasting glucose (FG) 126 mg/dL. Peripheral artery disease (PAD) was defined as ankle-arm index <0.9. Incident hip fractures were from medical records. Crude hip fracture rates (/1000 person-years) were higher for diabetic vs. non-diabetic participants with BMI <25 (13.6, 95% CI: 8.9–20.2 versus 11.4, 95% CI: 10.1–12.9) and BMI 25 to <30 (8.3, 95% CI: 5.7–11.9 versus 6.6, 95% CI: 5.6–7.7), but similar for BMI 30. Adjusting for BMI, sex, race, and age, diabetes was related to fractures (HR = 1.34; 95% CI: 1.01–1.78). PAD (HR = 1.25 (95% CI: 0.92–1.57)) and longer walk time (HR = 1.07 (95% CI: 1.04–1.10)) modified the fracture risk in diabetes (HR = 1.17 (95% CI: 0.87–1.57)). Diabetes was associated with higher hip fracture risk after adjusting for BMI though this association was modified by diabetes-related conditions.