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

• Published in: The journal of clinical endocrinology and metabolism Vol. 106; no. 9; pp. e3449 - e3460
• Main Authors: Kim, Jung A, Sung Lee, Ji, Song, Eyun, Roh, Eun, Hee Yu, Ji, Hoon Kim, Nam, Jin Yoo, Hye, Seo, Ji A, Gon Kim, Sin, Hee Kim, Nan, Hyun Baik, Sei, Mook Choi, Kyung
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01-09-2021
• Subjects: Analysis; Dextrose; Diabetes; Diabetes mellitus; Fasting; Glucose; Laboratory testing; Osteoporosis; Prognosis; Risk factors; Sensitivity analysis; Type 2 diabetes; Vertebrae; South Korea; osteoporosis; Fasting plasma glucose variability; fracture
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/clinem/dgab370

Abstract
Context
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.
Objective
We assessed visit-to-visit variations in fasting plasma glucose (FPG) as a prognostic factor in predicting osteoporotic fractures in individuals without diabetes.
Methods
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).
Results
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.
Conclusion
FPG variability may be a novel risk factor for osteoporotic fractures independent of risk factors in the general population without diabetes.