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First Asian study finds link between diabetes and osteoporosis
WHEN we think about long-term complications of diabetes, osteoporosis is not one that immediately comes to mind.
But researchers at the National University of Singapore (NUS) have found that Asians with diabetes, like their Western counterparts, experience an increased risk of hip fracture.
They are recommending that early assessment for loss of bone mass and increased fracture risk, as well as prevention of falls, be part of the management of diabetes.
Lead investigator Koh Woon Puay said Asian populations are registering rapid increases in the rates of diabetes and hip fracture but there is no prospective data linking both diseases in any Asian study.
“Our data in this study showed diabetes is a risk factor for osteoporotic hip fracture. A person with diabetes has
about double the risk of hip fracture compared to another person without diabetes,” said Associate Professor Koh, who is with the Department of Epidemiology and Public Health at the NUS Yong Loo Lin School of Medicine.
The team investigated the association of the two conditions using the Singapore Chinese Health Study, a cohort study of more than 63,000 Chinese aged between 45 and 74 years. The study was established between 1993 and 1998, and participants were followed up for a duration of 12 years.
The diabetes status was attained through interviews and the number of hip fractures was identified through a nationwide hospital discharge database.
The study, after excluding the 103 subjects with hip fractures prior to recruitment, found over 5,600 with diabetes. A follow-up after 12 years found over 1,200 cases of hip fracture in this cohort. There were significantly more women who had hip fractures – 871 compared to 342 men. And the risk of hip fracture among people with diabetes was twice that among those without diabetes.
Published last month in Diabetes Care, a journal by the American Diabetes Association, this is the first Asian study on the correlation between diabetes and osteoporosis. Its findings are identical to the combined results of 11 previous studies
done in the West.
“This study fills the existing void in information of Asian populations and confirms that the link between diabetes and increased hip fracture risk occurs across different populations with varying lifestyle or genetic make-up. We are confident the results in this study will apply to Malays and Indians as well,” Prof Koh said.
“We hope to share these findings with the public so doctors managing diabetes and diabetic patients themselves will test for osteoporosis early to reduce the risk of hip fracture.”
Her team is now studying other risk factors and the mortality rate of patients who have had hip fractures.
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