Does prediabetes increase risk for bone fractures in midlife women?

May 29, 2024 | Bone / Body Composition, News, SWAN Announcements

Does prediabetes increase risk for bone fractures in midlife women?

SWAN researcher Dr. Arun Karlamanga and associates examined that prospect in a recent study, determining that a significant risk was present for fractures in the menopause transition and in menopause. Another study found evidence suggesting that increased leisure time physical activity by women may mitigate that risk.

In the study on prediabetes risk, Dr. Karlamanga and associates evaluated information on 1,690 women in the SWAN cohort who did not have diabetes, finding that reporting prediabetes in medical visits before the menopause transition was an indicator of a 120% increased risk of bone fracture as opposed to women not reporting prediabetes in this time frame. Another study hypothesized that increased leisure physical time activity from pre- and early-perimenopause to late perimenopause/postmenopause would be associated with slower period 2 bone mineral density loss.

The main objective of this cohort study, “Prediabetes and Fracture Risk Among Midlife Women in the Study of Women’s Health Across the Nation,” published in Jama Network Open in May 2023, was to determine whether having prediabetes before the menopause transition (MT) is associated with the occurrence of bone fractures during and after MT. “Diabetic bone disease” as well as bone fractures are noted as a complication of diabetes, but the study looked for a clinically relevant association with women having prediabetes. Having prediabetes is associated with risk for diabetes, but whether prediabetes is associated with risk for fractures is not known.

The study first examined whether prediabetes among midlife women is associated with subsequent fracture when type 2 diabetes is not present. Midlife is when the MT occurs and when fracture risk accelerates. Since prediabetes may affect bone mineral density (BMD), researchers also sought to assess whether the potential association of prediabetes with fracture was independent of BMD. Having prediabetes more consistently before the MT was associated with greater rates of fracture during the MT or in postmenopause. Future research should determine whether treating prediabetes reduces fracture risk.

A related study, “Leisure time physical activity and bone mineral density preservation during the menopause transition and postmenopause: a longitudinal cohort analysis from the Study of Women’s Health Across the Nation (SWAN)” was published in Lancet Regional Health – Americas in March 2023. This study sought to determine if leisure time physical activity (LTPA) has an effect on BMD during MT. Study findings suggest that modest levels of LTPA, with walking being the most common among the SWAN cohort, do lessen BMD related decline in the MT period. Another hypothesis was that even small increases in common LTPA functions might reduce bone loss at population levels.

 

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