Prevalent Morphometrically Assessed Vertebral Fractures in Individuals With Type 2 Diabetes, Prediabetes and Normal Glucose Metabolism: The Maastricht Study

Veerle van Hulten; Cindy Sarodnik; Johanna H M Driessen; Nicolaas C Schaper; Piet P M M Geusens; Carol A B Webers; Geert-Jan Dinant; Ramon P G Ottenheijm; Nicklas H Rasmussen; Rikke Viggers; Coen D A Stehouwer; Carla J H van der Kallen; Miranda T Schram; Sandrine P G Bours; Pieter C Dagnelie; Joop P van den Bergh

doi:10.3389/fendo.2022.832977

Prevalent Morphometrically Assessed Vertebral Fractures in Individuals With Type 2 Diabetes, Prediabetes and Normal Glucose Metabolism: The Maastricht Study

Veerle van Hulten, Cindy Sarodnik, Johanna H M Driessen, Nicolaas C Schaper, Piet P M M Geusens, Carol A B Webers, Geert-Jan Dinant, Ramon P G Ottenheijm, Nicklas H Rasmussen, Rikke Viggers, Coen D A Stehouwer, Carla J H van der Kallen, Miranda T Schram, Sandrine P G Bours, Pieter C Dagnelie, Joop P van den Bergh^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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.

Original language	English
Article number	832977
Number of pages	9
Journal	Frontiers in Endocrinology
Volume	13
DOIs	https://doi.org/10.3389/fendo.2022.832977
Publication status	Published - 18 Feb 2022

Keywords

ASSOCIATION
BONE-MINERAL DENSITY
COMPLICATIONS
DEFORMITIES
MORTALITY
OSTEOPOROSIS
RISK
SEX-HORMONES
WOMEN
bone
dual energy X-ray absorptiometry (DEXA)
type 2 diabetes
vertebral fracture (VF)
vertebral fracture assessment (VFA)

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Cite this

van Hulten, V., Sarodnik, C., Driessen, J. H. M., Schaper, N. C., Geusens, P. P. M. M., Webers, C. A. B., Dinant, G.-J., Ottenheijm, R. P. G., Rasmussen, N. H., Viggers, R., Stehouwer, C. D. A., van der Kallen, C. J. H., Schram, M. T., Bours, S. P. G., Dagnelie, P. C., & van den Bergh, J. P. (2022). Prevalent Morphometrically Assessed Vertebral Fractures in Individuals With Type 2 Diabetes, Prediabetes and Normal Glucose Metabolism: The Maastricht Study. Frontiers in Endocrinology, 13, Article 832977. https://doi.org/10.3389/fendo.2022.832977

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title = "Prevalent Morphometrically Assessed Vertebral Fractures in Individuals With Type 2 Diabetes, Prediabetes and Normal Glucose Metabolism: The Maastricht Study",

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.",

keywords = "ASSOCIATION, BONE-MINERAL DENSITY, COMPLICATIONS, DEFORMITIES, MORTALITY, OSTEOPOROSIS, RISK, SEX-HORMONES, WOMEN, bone, dual energy X-ray absorptiometry (DEXA), type 2 diabetes, vertebral fracture (VF), vertebral fracture assessment (VFA)",

author = "{van Hulten}, Veerle and Cindy Sarodnik and Driessen, {Johanna H M} and Schaper, {Nicolaas C} and Geusens, {Piet P M M} and Webers, {Carol A B} and Geert-Jan Dinant and Ottenheijm, {Ramon P G} and Rasmussen, {Nicklas H} and Rikke Viggers and Stehouwer, {Coen D A} and {van der Kallen}, {Carla J H} and Schram, {Miranda T} and Bours, {Sandrine P G} and Dagnelie, {Pieter C} and {van den Bergh}, {Joop P}",

note = "Copyright {\textcopyright} 2022 van Hulten, Sarodnik, Driessen, Schaper, Geusens, Webers, Dinant, Ottenheijm, Rasmussen, Viggers, Stehouwer, van der Kallen, Schram, Bours, Dagnelie and van den Bergh.",

year = "2022",

month = feb,

day = "18",

doi = "10.3389/fendo.2022.832977",

language = "English",

volume = "13",

journal = "Frontiers in Endocrinology",

issn = "1664-2392",

publisher = "Frontiers Media S.A.",

}

van Hulten, V , Sarodnik, C , Driessen, JHM, Schaper, NC, Geusens, PPMM, Webers, CAB , Dinant, G-J , Ottenheijm, RPG, Rasmussen, NH, Viggers, R, Stehouwer, CDA , van der Kallen, CJH , Schram, MT , Bours, SPG , Dagnelie, PC & van den Bergh, JP 2022, 'Prevalent Morphometrically Assessed Vertebral Fractures in Individuals With Type 2 Diabetes, Prediabetes and Normal Glucose Metabolism: The Maastricht Study', Frontiers in Endocrinology, vol. 13, 832977. https://doi.org/10.3389/fendo.2022.832977

TY - JOUR

T1 - Prevalent Morphometrically Assessed Vertebral Fractures in Individuals With Type 2 Diabetes, Prediabetes and Normal Glucose Metabolism

T2 - The Maastricht Study

AU - van Hulten, Veerle

AU - Sarodnik, Cindy

AU - Driessen, Johanna H M

AU - Schaper, Nicolaas C

AU - Geusens, Piet P M M

AU - Webers, Carol A B

AU - Dinant, Geert-Jan

AU - Ottenheijm, Ramon P G

AU - Rasmussen, Nicklas H

AU - Viggers, Rikke

AU - Stehouwer, Coen D A

AU - van der Kallen, Carla J H

AU - Schram, Miranda T

AU - Bours, Sandrine P G

AU - Dagnelie, Pieter C

AU - van den Bergh, Joop P

PY - 2022/2/18

Y1 - 2022/2/18

N2 - 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.

AB - 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.

KW - ASSOCIATION

KW - BONE-MINERAL DENSITY

KW - COMPLICATIONS

KW - DEFORMITIES

KW - MORTALITY

KW - OSTEOPOROSIS

KW - RISK

KW - SEX-HORMONES

KW - WOMEN

KW - bone

KW - dual energy X-ray absorptiometry (DEXA)

KW - type 2 diabetes

KW - vertebral fracture (VF)

KW - vertebral fracture assessment (VFA)

U2 - 10.3389/fendo.2022.832977

DO - 10.3389/fendo.2022.832977

M3 - Article

C2 - 35250885

SN - 1664-2392

VL - 13

JO - Frontiers in Endocrinology

JF - Frontiers in Endocrinology

M1 - 832977

ER -