Type 1 and 2 diabetes mellitus: comprehensive fracture risk: relationships in UK Biobank
Type 1 and 2 diabetes mellitus: comprehensive fracture risk: relationships in UK Biobank
We aimed to investigate associations between diabetes mellitus and incident fracture, stratified by diabetes type (1 or 2), disease duration and microvascular complications of diabetes. This prospective cohort analysis used data from the UK Biobank, a large population-based cohort of participants recruited 2006-2010 at age 40-69 yr. The exposure was type 1 or type 2 diabetes at baseline, with the outcome of first incident osteoporotic fracture. Poisson regression was used to calculate incidence rate ratios (IRRs) for osteoporotic fracture to investigate prospective relationships between diabetes type 1 or 2 and fracture risk independent of traditional clinical risk factors, estimated bone mineral density by heel ultrasound (eBMD), adiposity, and C-reactive protein. The role of diabetic microvascular complications and associations between diabetes duration and fracture risk were studied. There were 498 949 participants (271 882 women, mean age 56 yr; 227 067 men, 57 yr). In fully adjusted models, type 1 and 2 diabetes were associated with increased fracture risk [type 1; IRR: 2.93 (95%CI:2.37,3.62); type 2: 1.25 (1.14,1.38)], similar by sex. The magnitude of risk associated with type 2 diabetes increased with duration of disease. Increasing number of microvascular complications was associated with greater fracture risk [any vs no complications, IRR 2.03 (1.57,2.62)]. Diabetes is associated with increased risk of fracture (magnitude of effect greater in type 1 than type 2 diabetes). Associations were partly independent of traditional risk factors, adiposity, eBMD and CRP. Type 2 diabetes disease duration and the presence of microvascular complications in both types were dose-dependent risk factors for fracture.
Curtis, Elizabeth M.
12aba0c3-1e9e-49ef-a7e9-3247e649cdd6
Moon, Rebecca J.
954fb3ed-9934-4649-886d-f65944985a6b
D'Angelo, Stefania
13375ecd-1117-4b6e-99c0-32239f52eed6
Raisi-Estabragh, Zahra
43c85c5e-4574-476b-80d6-8fb1cdb3df0a
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Harvey, Nicholas C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Curtis, Elizabeth M.
12aba0c3-1e9e-49ef-a7e9-3247e649cdd6
Moon, Rebecca J.
954fb3ed-9934-4649-886d-f65944985a6b
D'Angelo, Stefania
13375ecd-1117-4b6e-99c0-32239f52eed6
Raisi-Estabragh, Zahra
43c85c5e-4574-476b-80d6-8fb1cdb3df0a
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Harvey, Nicholas C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Curtis, Elizabeth M., Moon, Rebecca J., D'Angelo, Stefania, Raisi-Estabragh, Zahra, Cooper, Cyrus and Harvey, Nicholas C.
(2025)
Type 1 and 2 diabetes mellitus: comprehensive fracture risk: relationships in UK Biobank.
Journal of Bone and Mineral Research, [zjaf094].
(doi:10.1093/jbmr/zjaf094).
Abstract
We aimed to investigate associations between diabetes mellitus and incident fracture, stratified by diabetes type (1 or 2), disease duration and microvascular complications of diabetes. This prospective cohort analysis used data from the UK Biobank, a large population-based cohort of participants recruited 2006-2010 at age 40-69 yr. The exposure was type 1 or type 2 diabetes at baseline, with the outcome of first incident osteoporotic fracture. Poisson regression was used to calculate incidence rate ratios (IRRs) for osteoporotic fracture to investigate prospective relationships between diabetes type 1 or 2 and fracture risk independent of traditional clinical risk factors, estimated bone mineral density by heel ultrasound (eBMD), adiposity, and C-reactive protein. The role of diabetic microvascular complications and associations between diabetes duration and fracture risk were studied. There were 498 949 participants (271 882 women, mean age 56 yr; 227 067 men, 57 yr). In fully adjusted models, type 1 and 2 diabetes were associated with increased fracture risk [type 1; IRR: 2.93 (95%CI:2.37,3.62); type 2: 1.25 (1.14,1.38)], similar by sex. The magnitude of risk associated with type 2 diabetes increased with duration of disease. Increasing number of microvascular complications was associated with greater fracture risk [any vs no complications, IRR 2.03 (1.57,2.62)]. Diabetes is associated with increased risk of fracture (magnitude of effect greater in type 1 than type 2 diabetes). Associations were partly independent of traditional risk factors, adiposity, eBMD and CRP. Type 2 diabetes disease duration and the presence of microvascular complications in both types were dose-dependent risk factors for fracture.
Text
UKB diabetes and bone paper JBMR 2025_06_06 R1 clean
- Accepted Manuscript
More information
Accepted/In Press date: 1 July 2025
e-pub ahead of print date: 11 July 2025
Additional Information:
For the purpose of Open Access, the author has applied a Creative
Commons Attribution (CC BY) licence to any Author Accepted Manuscript version arising from this submission.
Identifiers
Local EPrints ID: 503972
URI: http://eprints.soton.ac.uk/id/eprint/503972
ISSN: 0884-0431
PURE UUID: 9a0fdf8b-3f9e-4d7c-8d5f-def73be7717f
Catalogue record
Date deposited: 19 Aug 2025 17:05
Last modified: 20 Aug 2025 01:56
Export record
Altmetrics
Contributors
Author:
Rebecca J. Moon
Author:
Stefania D'Angelo
Author:
Zahra Raisi-Estabragh
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics