Fat infiltration of muscle, diabetes, and clinical fracture risk in older adults

Anne L. Schafer, Eric Vittinghoff, Thomas F. Lang, Deborah E. Sellmeyer, Tamara B. Harris, Alka M. Kanaya, Elsa S. Strotmeyer, Peggy M. Cawthon, Steven R. Cummings, Frances Tylavsky, Ann L. Scherzinger, Ann V. Schwartz

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Abstract

Context: Older adults with type 2 diabetes are at higher risk for fracture compared with nondiabetic adults after adjustment for their higher bone mineral density. Infiltration of muscle by fat predicts increased risk of hip fracture. Objective: We investigated whether fat infiltration of muscle, which is greater in diabetic adults, is associated with all clinical fracture and whether it accounts for the increased fracture risk in those with diabetes. Design, Setting, and Participants: Data were analyzed from the Health, Aging, and Body Composition Study, a cohort of community-dwelling adults aged 70-79 yr. Glucose metabolism status and x-ray attenuation of thigh muscle were determined at baseline for 2762 participants. Main Outcome Measures: During a mean 8.2 ± 2.3 yr follow-up, 331 participants reported at least one clinical fracture. Results: Fat infiltration of muscle was higher in those with diabetes or impaired glucose metabolism than in those with normal glucose metabolism (P < 0.001). Fat infiltration of muscle was independently associated with a 19% increased risk of incident clinical fracture (multivariate hazard ratio = 1.19;95%confidence interval = 1.04-1.36); this association did not differ across glucose metabolism groups (P for interaction = 0.65). As previously reported, diabetes was associated with a greater fracture risk compared with normal glucose metabolism (hazard ratio = 1.42; 95% confidence interval = 1.07-1.89) after adjustment forbonemineral density, but further adjustment for fat infiltration of muscle did not attenuate this association. Conclusions: Fat infiltration of muscle predicts clinical fracture in older adults. Although fat infiltration of muscle is higher among those with diabetes, it does not account for their increased fracture risk.

Original languageEnglish (US)
JournalJournal of Clinical Endocrinology and Metabolism
Volume95
Issue number11
DOIs
StatePublished - Jan 1 2010

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Medical problems
Infiltration
Muscle
Fats
Muscles
Metabolism
Glucose
Hazards
Confidence Intervals
Independent Living
Association reactions
Hip Fractures
Thigh
Body Composition
Bone Density
Type 2 Diabetes Mellitus
Cohort Studies
Minerals
Bone
X-Rays

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Schafer, A. L., Vittinghoff, E., Lang, T. F., Sellmeyer, D. E., Harris, T. B., Kanaya, A. M., ... Schwartz, A. V. (2010). Fat infiltration of muscle, diabetes, and clinical fracture risk in older adults. Journal of Clinical Endocrinology and Metabolism, 95(11). https://doi.org/10.1210/jc.2010-0780

Fat infiltration of muscle, diabetes, and clinical fracture risk in older adults. / Schafer, Anne L.; Vittinghoff, Eric; Lang, Thomas F.; Sellmeyer, Deborah E.; Harris, Tamara B.; Kanaya, Alka M.; Strotmeyer, Elsa S.; Cawthon, Peggy M.; Cummings, Steven R.; Tylavsky, Frances; Scherzinger, Ann L.; Schwartz, Ann V.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 95, No. 11, 01.01.2010.

Research output: Contribution to journalArticle

Schafer, AL, Vittinghoff, E, Lang, TF, Sellmeyer, DE, Harris, TB, Kanaya, AM, Strotmeyer, ES, Cawthon, PM, Cummings, SR, Tylavsky, F, Scherzinger, AL & Schwartz, AV 2010, 'Fat infiltration of muscle, diabetes, and clinical fracture risk in older adults', Journal of Clinical Endocrinology and Metabolism, vol. 95, no. 11. https://doi.org/10.1210/jc.2010-0780
Schafer, Anne L. ; Vittinghoff, Eric ; Lang, Thomas F. ; Sellmeyer, Deborah E. ; Harris, Tamara B. ; Kanaya, Alka M. ; Strotmeyer, Elsa S. ; Cawthon, Peggy M. ; Cummings, Steven R. ; Tylavsky, Frances ; Scherzinger, Ann L. ; Schwartz, Ann V. / Fat infiltration of muscle, diabetes, and clinical fracture risk in older adults. In: Journal of Clinical Endocrinology and Metabolism. 2010 ; Vol. 95, No. 11.
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abstract = "Context: Older adults with type 2 diabetes are at higher risk for fracture compared with nondiabetic adults after adjustment for their higher bone mineral density. Infiltration of muscle by fat predicts increased risk of hip fracture. Objective: We investigated whether fat infiltration of muscle, which is greater in diabetic adults, is associated with all clinical fracture and whether it accounts for the increased fracture risk in those with diabetes. Design, Setting, and Participants: Data were analyzed from the Health, Aging, and Body Composition Study, a cohort of community-dwelling adults aged 70-79 yr. Glucose metabolism status and x-ray attenuation of thigh muscle were determined at baseline for 2762 participants. Main Outcome Measures: During a mean 8.2 ± 2.3 yr follow-up, 331 participants reported at least one clinical fracture. Results: Fat infiltration of muscle was higher in those with diabetes or impaired glucose metabolism than in those with normal glucose metabolism (P < 0.001). Fat infiltration of muscle was independently associated with a 19{\%} increased risk of incident clinical fracture (multivariate hazard ratio = 1.19;95{\%}confidence interval = 1.04-1.36); this association did not differ across glucose metabolism groups (P for interaction = 0.65). As previously reported, diabetes was associated with a greater fracture risk compared with normal glucose metabolism (hazard ratio = 1.42; 95{\%} confidence interval = 1.07-1.89) after adjustment forbonemineral density, but further adjustment for fat infiltration of muscle did not attenuate this association. Conclusions: Fat infiltration of muscle predicts clinical fracture in older adults. Although fat infiltration of muscle is higher among those with diabetes, it does not account for their increased fracture risk.",
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AU - Schafer, Anne L.

AU - Vittinghoff, Eric

AU - Lang, Thomas F.

AU - Sellmeyer, Deborah E.

AU - Harris, Tamara B.

AU - Kanaya, Alka M.

AU - Strotmeyer, Elsa S.

AU - Cawthon, Peggy M.

AU - Cummings, Steven R.

AU - Tylavsky, Frances

AU - Scherzinger, Ann L.

AU - Schwartz, Ann V.

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Y1 - 2010/1/1

N2 - Context: Older adults with type 2 diabetes are at higher risk for fracture compared with nondiabetic adults after adjustment for their higher bone mineral density. Infiltration of muscle by fat predicts increased risk of hip fracture. Objective: We investigated whether fat infiltration of muscle, which is greater in diabetic adults, is associated with all clinical fracture and whether it accounts for the increased fracture risk in those with diabetes. Design, Setting, and Participants: Data were analyzed from the Health, Aging, and Body Composition Study, a cohort of community-dwelling adults aged 70-79 yr. Glucose metabolism status and x-ray attenuation of thigh muscle were determined at baseline for 2762 participants. Main Outcome Measures: During a mean 8.2 ± 2.3 yr follow-up, 331 participants reported at least one clinical fracture. Results: Fat infiltration of muscle was higher in those with diabetes or impaired glucose metabolism than in those with normal glucose metabolism (P < 0.001). Fat infiltration of muscle was independently associated with a 19% increased risk of incident clinical fracture (multivariate hazard ratio = 1.19;95%confidence interval = 1.04-1.36); this association did not differ across glucose metabolism groups (P for interaction = 0.65). As previously reported, diabetes was associated with a greater fracture risk compared with normal glucose metabolism (hazard ratio = 1.42; 95% confidence interval = 1.07-1.89) after adjustment forbonemineral density, but further adjustment for fat infiltration of muscle did not attenuate this association. Conclusions: Fat infiltration of muscle predicts clinical fracture in older adults. Although fat infiltration of muscle is higher among those with diabetes, it does not account for their increased fracture risk.

AB - Context: Older adults with type 2 diabetes are at higher risk for fracture compared with nondiabetic adults after adjustment for their higher bone mineral density. Infiltration of muscle by fat predicts increased risk of hip fracture. Objective: We investigated whether fat infiltration of muscle, which is greater in diabetic adults, is associated with all clinical fracture and whether it accounts for the increased fracture risk in those with diabetes. Design, Setting, and Participants: Data were analyzed from the Health, Aging, and Body Composition Study, a cohort of community-dwelling adults aged 70-79 yr. Glucose metabolism status and x-ray attenuation of thigh muscle were determined at baseline for 2762 participants. Main Outcome Measures: During a mean 8.2 ± 2.3 yr follow-up, 331 participants reported at least one clinical fracture. Results: Fat infiltration of muscle was higher in those with diabetes or impaired glucose metabolism than in those with normal glucose metabolism (P < 0.001). Fat infiltration of muscle was independently associated with a 19% increased risk of incident clinical fracture (multivariate hazard ratio = 1.19;95%confidence interval = 1.04-1.36); this association did not differ across glucose metabolism groups (P for interaction = 0.65). As previously reported, diabetes was associated with a greater fracture risk compared with normal glucose metabolism (hazard ratio = 1.42; 95% confidence interval = 1.07-1.89) after adjustment forbonemineral density, but further adjustment for fat infiltration of muscle did not attenuate this association. Conclusions: Fat infiltration of muscle predicts clinical fracture in older adults. Although fat infiltration of muscle is higher among those with diabetes, it does not account for their increased fracture risk.

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