Dr Cauley received support from Eli Lilly and Company, Pfizer, and Novartis. She received an honorarium from Eli Lilly and Company, Merck, and Novartis and served as a speaker for Eli Lilly and Company and Merck. All other authors have no conflict of interest.
Diabetes and Bone Loss at the Hip in Older Black and White Adults†
Article first published online: 13 DEC 2004
Copyright © 2005 ASBMR
Journal of Bone and Mineral Research
Volume 20, Issue 4, pages 596–603, April 2005
How to Cite
Schwartz, A. V., Sellmeyer, D. E., Strotmeyer, E. S., Tylavsky, F. A., Feingold, K. R., Resnick, H. E., Shorr, R. I., Nevitt, M. C., Black, D. M., Cauley, J. A., Cummings, S. R. and Harris, T. B. (2005), Diabetes and Bone Loss at the Hip in Older Black and White Adults. J Bone Miner Res, 20: 596–603. doi: 10.1359/JBMR.041219
This paper was presented in part as an abstract at the 25th Annual Meeting of the American Society for Bone and Mineral Research in Minneapolis, Minnesota, USA, September 19-23, 2003.
- Issue published online: 4 DEC 2009
- Article first published online: 13 DEC 2004
- Manuscript Revised: 9 DEC 2004
- Manuscript Accepted: 9 DEC 2004
- Manuscript Received: 29 JUN 2004
- diabetes mellitus;
- longitudinal studies;
Type 2 diabetes may be associated with elevated fracture risk, but the impact on bone loss is unknown. Analysis of 4-year change in hip BMD data from a cohort of white and black well-functioning men and women 70-79 years of age found that white women with diabetes had more rapid bone loss at the femoral neck than those with normal glucose metabolism.
Introduction: Type 2 diabetes may be associated with elevated fracture risk in older adults. Although type 2 diabetes is not associated with lower BMD, older diabetic adults have a higher prevalence of other risk factors for fracture, including more frequent falls, functional limitations, and diabetic complications. With this burden of risk factors, loss of BMD could place older adults with diabetes at higher risk of sustaining a fracture.
Materials and Methods: To determine if bone loss is increased with type 2 diabetes, we analyzed data from the Health, Aging, and Body Composition Study of white and black well-functioning men and women 70-79 years of age. Hip BMD was measured at baseline and 4 years later in 480 (23%) participants with diabetes, 439 with impaired glucose metabolism, and 1172 with normal glucose homeostasis (NG).
Results: Those with diabetes had higher baseline hip BMD and weight, but among white women, had more weight loss over 4 years. White women with diabetes lost more femoral neck and total hip BMD than those with NG in age-adjusted models. After multivariable adjustment, diabetes was associated with greater loss of femoral neck BMD (−0.32%/year; 95% CI: −0.61, −0.02) but not total hip BMD. In men and black women, change in hip BMD was similar for participants with diabetes and NG.
Conclusions: Despite having higher baseline BMD, diabetic white women, but not men or black women, had more rapid bone loss at the femoral neck than those with NG. This increased bone loss may contribute to the higher fracture risk observed in older diabetic women.