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van Hulten V, Sarodnik C, Driessen JHM, Schaper NC, Geusens PPMM, Webers CAB, Dinant GJ, Ottenheijm RPG, Rasmussen NH, Viggers R, Stehouwer CDA, van der Kallen CJH, Schram MT, Bours SPG, Dagnelie PC, van den Bergh JP. Prevalent Morphometrically Assessed Vertebral Fractures in Individuals With Type 2 Diabetes, Prediabetes and Normal Glucose Metabolism: The Maastricht Study. Front Endocrinol (Lausanne) 2022; 13:832977. [PMID: 35250885 PMCID: PMC8894595 DOI: 10.3389/fendo.2022.832977] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 01/24/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Type 2 diabetes (T2D) is frequently reported to be associated with an increased fracture risk. Epidemiological data on prevalent morphometric vertebral fractures (VFs) in T2D are sparse and even less is known in the prediabetic state. PURPOSE To determine the association between prevalence and severity of morphometric VFs and glucose metabolism state: normal glucose metabolism (NGM), impaired glucose metabolism (prediabetes) or T2D. METHODS This study included cross-sectional data from 3625 participants of the Maastricht Study who had a vertebral fracture assessment on lateral Dual Energy X-Ray Absorptiometry images. VFs were classified based on morphometric assessment into mild, moderate and severe VFs (respectively 20-24%, 25-39% or ≥40% reduction in expected vertebral body height). Logistic regression models were used to investigate the association between glucose metabolism status and the prevalence and severity of VFs. Analyses were adjusted for subject characteristics and life-style factors. RESULTS T2D individuals were older (62.8 ± 7.5 years old) and less often female (30.5%) compared to the NGM group (57.7 ± 8.5 years old, and 58.8% female, respectively). At least one mild, moderate or severe prevalent VF was found in 8.6% of the men and 2.2% of the women in the T2D group, in 9.4% and 8.4% in the prediabetes group and in 9.1% and 4.8% in the NGM group, respectively. After adjustment T2D in women was associated with a lower probability of having a prevalent VF compared to NGM [adjusted OR 0.25 (95% CI 0.09-0.65)], while this was not the case for prediabetes. Furthermore, women with T2D had a significantly lower probability of a prevalent moderate or severe VF [adjusted OR 0.32 (95% CI 0.11-0.96)]. In men there was no significant association between T2D or prediabetes and prevalent VFs. CONCLUSION Women with T2D had a lower probability of prevalent VFs compared to women with a normal glucose metabolism, while this was not the case for men with T2D and participants with prediabetes.
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Affiliation(s)
- Veerle van Hulten
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Cindy Sarodnik
- Division of Rheumatology, Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
| | - Johanna H. M. Driessen
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Nicolaas C. Schaper
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Piet P. M. M. Geusens
- Division of Rheumatology, Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
- Biomedical Research Institute, University Hasselt, Hasselt, Belgium
| | - Carol A. B. Webers
- University Eye Clinic Maastricht, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
| | - Geert-Jan Dinant
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Ramon P. G. Ottenheijm
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Nicklas H. Rasmussen
- Steno Diabetes Center North Jutland, Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
| | - Rikke Viggers
- Steno Diabetes Center North Jutland, Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Coen D. A. Stehouwer
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
| | - Carla J. H. van der Kallen
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
| | - Miranda T. Schram
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+ (MUMC+), Maastricht, Netherlands
| | - Sandrine P. G. Bours
- Division of Rheumatology, Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Pieter C. Dagnelie
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, Netherlands
| | - Joop P. van den Bergh
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
- Subdivision of Endocrinology, Department of Internal Medicine, VieCuri Medical Center, Venlo, Netherlands
- *Correspondence: Joop P. van den Bergh,
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