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ISRN Epidemiology
Volume 2013, Article ID 249874, 6 pages
http://dx.doi.org/10.5402/2013/249874
Research Article

Risk Factors for Fracture in Diabetes: The Canadian Multicentre Osteoporosis Study

1Department of Medicine, University of Western Ontario, 339 Windermere Road, London, ON, Canada N6A 5A5
2Division of Endocrinology and Metabolism, St. Joseph’s Hospital, 268 Grosvenor Street, London, ON, Canada N6A 4V2
3Department of Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4K1
4Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4K1
5Centre for Evaluation of Medicines, St. Joseph’s Healthcare, 50 Charlton Avenue East, Hamilton, ON, Canada L8N 4A6

Received 29 July 2013; Accepted 25 August 2013

Academic Editors: N. B. Kandala and C. M. Maylahn

Copyright © 2013 Lisa-Ann Fraser 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.

Abstract

Objective. Individuals with diabetes have been found to be at increased risk of nontraumatic fracture. However, within the diabetic population, how to distinguish who is at the highest risk and warranting therapy has remained elusive. Design. Cross-sectional analysis of a national population-based cohort study. Patients. Men and women over the age of 50 with diabetes from across Canada. Measurements. Logistic regression analysis to identify diabetes specific factors associated with a history of one or more non-traumatic fractures. Results. Six hundred and six individuals with diabetes with a mean age of 69 years were examined. Thirty percent had a history of non-traumatic fracture. Macrovascular diseases in the form of stroke or TIA, as well as hypertension, were found to be independently associated with fragility fracture. Other, more traditional, clinical risk factors were also associated with fracture, including increased age, female gender, rheumatoid arthritis, family history of osteoporosis, and decreased bone mineral density. Conclusions. In this cohort of Canadians with diabetes, those with rheumatoid arthritis, a family history of osteoporosis, female gender, increased age, decreased BMD, cerebrovascular disease, or hypertension were more likely to have had a non-traumatic fracture. These risk factors may be important to clinicians when identifying which of their diabetic patients are at highest risk of fracture and in need of preventative therapies.