Association Between Visit-to-Visit Fasting Plasma Glucose Variability and Osteoporotic Fractures in Nondiabetic Subjects.

Kim, Jung A.; Ji Sung Lee; Eyun Song; Eun Roh; Ji Hee Yu; Nam Hoon Kim; Hye Jin Yoo; Seo, Ji A.; Sin Gon Kim; Nan Hee Kim; Sei Hyun Baik; Kyung Mook Choi; Sung Lee, Ji; Song, Eyun; Roh, Eun; Hee Yu, Ji; Hoon Kim, Nam; Jin Yoo, Hye; Gon Kim, Sin; Hee Kim, Nan

<bold>Context: </bold>Although long-term glucose variability has been reported to be a risk factor associated with osteoporosis, there have been no previous studies between the relationship of glucose variability and fractures in people without diabetes.<bold>Objective: </bold>We assessed visit-to-visit variations in fasting plasma glucose (FPG) as a prognostic factor in predicting osteoporotic fractures in individuals without diabetes.<bold>Methods: </bold>Using a nationwide cohort database, we examined the impact of FPG on the development of osteoporotic fractures in men and women (aged ≥50 years). The primary outcomes were the number of total fractures and vertebral fractures. FPG variability was measured using standard deviation (FPG-SD), coefficient of variation (FPG-CV), and variability independent of the mean (FPG-VIM).<bold>Results: </bold>Of the 92 929 participants, 5262 (5.7%) developed osteoporotic fractures during the mean follow-up of 8.4 years. Individuals in the highest quartile of FPG-SD showed an 11% and 16% increase in risk of total and vertebral fractures, respectively, compared with those in the lowest quartile after adjustment for mean FPG and other risk factors. Analyses using FPG-CV and FPG-VIM demonstrated similar results. Subgroup analyses and sensitivity analyses to explore potential heterogeneity showed consistent results.<bold>Conclusion: </bold>FPG variability may be a novel risk factor for osteoporotic fractures independent of risk factors in the general population without diabetes.

CALCIUM supplements; BLOOD sugar; BONE fractures; TERIPARATIDE; WRIST fractures; MEDICAL research; CARDIOVASCULAR diseases

Journal of Clinical Endocrinology & Metabolism, 2021, Vol 106, Issue 9, pe3449

0021-972X

Academic Journal

10.1210/clinem/dgab370