Increased prevalence of self-reported fractures in Asian Indians with diabetes:​ results from the ICMR-INDIAB population based cross-sectional study

Kaur, Parjeet; Anjana, Ranjit Mohan; Tandon, Nikhil; Singh, Manish Kumar; Mohan, Viswanathan; Mithal, Ambrish

Affiliations

¹Division of Endocrinology and Diabetes, Medanta The Medicity Hospital, Gurugram, Haryana, India

²Dr. Mohan's Diabetes Specialties Centre & Madras Diabetes Research Foundation, Chennai, India

³Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India

⁴Department of Clinical Research and Studies, Medanta-The Medicity Hospital, Gurugram, Haryana, India

Abstract and keywords

Background: Diabetes mellitus (DM), has been associated with increased fracture risk. However, there are no data pertaining to the prevalence of fractures for patients with DM in India. The aim of this study was to determine the prevalence of fractures in Asian Indians with and without diabetes.

Methods: The study used the data of Indian Council of Medical Research–India Diabetes (ICMR–INDIAB) study, a community- based cross sectional survey conceived with the aim of obtaining the prevalence rates of diabetes in India as a whole. A community-based sample of 57,117 individuals aged ≥20 years was obtained. Diabetes was diagnosed by oral glucose tolerance test using capillary blood (except in self-reported diabetes). Fractures were self-reported.

Results: Fracture data were available in 54,093 subjects. Out of these, 1416 (2.6%) had fractures. Overall prevalence of diabetes and prediabetes was 7.1% and 10.5% respectively. Prevalence of fractures was significantly higher in diabetes group (4%) compared with non-diabetes group (2.5%). In multivariate logistic regression analysis, diabetes was associated with an increased risk (1) of any fracture (OR=1.28, 95% CI: 1.07–1.5) and (2) of low trauma fracture (hip and spine combined) (OR = 1.8, 95% CI:1.1–2.8). After gender stratification, diabetes was a risk factor for fracture only in women. Age (>40 years) in women, high waist circumference (>90 cm) in men, alcohol consumption and urban residence in both men and women were other significant contributors to fracture risk.

Conclusion: Increased prevalence of self-reported fractures was seen in individuals with diabetes in this population-based study from India.

Keywords: Diabetes mellitus; India; Fractures; Osteoporosis; Population-based

Links

DOI: 10.1016/j.bone.2020.115323

PubMed: 32200024

WoS: 000530069000014

History

Received: 2019-11-9

Revised: 2020-03-16

Accepted: 2020-03-16

Online: 2020-03-19

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