Degree of Joint Risk Factor Control and Incident Fracture Outcomes in Individuals With Type 2 Diabetes
Main finding · Overall fracturesResult — go to the resultHazard ratio 0.50 95% CI 0.33–0.75Authors' conclusion
Joint risk factor control was significantly linked to a reduced fracture risk, and optimal management may eliminate the excess fracture risk associated with type 2 diabetes.
Study context
- Population
- Individuals with T2D and matched controls without fractures at baseline, UK Biobank; six modifiable risk factors: Body mass index (BMI), physical activity, smoking, alcohol, serum 25(OH)D, hemoglobin A1c (HbA1c)matched cohort
- Participants
- 8,935 vs 35,740
- Exposure
- Degree of joint risk factor control in T2D; T2D vs matched nondiabetic controls
- T2Dn = 8,935
- Controlsn = 35,740reference
- Outcome
- Incident fracture outcomes by number of controlled risk factors
- Follow-up
- Median 12.1 years
Methodological detailsUK Biobank, Cox proportional hazards models
- UK Biobank
- Cox proportional hazards models
Main finding
Overall fractures
Hazard ratio
0.50
95% CI 0.33–0.75
Optimal control (≥5 risk factors)
HR 0.50 (95% CI 0.33–0.75)
As reported in the abstract
- Fracture risk decrease per each additional risk factor controlled
- 14% to 26%
Observational data: associations, not effects.
Further findings
Hip fractures
| HR (95% CI) | ||
|---|---|---|
| Control of 4 risk factors60% reduction in hip fractures | 0.40 (0.16–0.98) | |
| 0.10.31310Hazard ratio (log scale) |
Fracture risk in T2D vs nondiabetic controls
- With control of ≥4 risk factors, fracture risk in T2D was comparable to nondiabetic controls
- Protective effect stronger in men than in women
Original publication
Degree of Joint Risk Factor Control and Incident Fracture Outcomes in Individuals With Type 2 Diabetes. J Clin Endocrinol Metab. Published 13 March 2025. doi:10.
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