Aim: Diabetes Mellitus is associated with an increased risk of fractures, which is not explained fully by bone mineral density and common risk factors. The aim of this study is to investigate the association of medication and biochemical markers on the risk of fracture in a diabetes population. Methods: Nested case-control study based on Danish diabetes patients from The Danish National Hospital Discharge Registry. The cases of the study were diabetes patients with a fracture (n= 24,349) and controls were diabetes patients with no fracture (n=132,349). A total of 2,816 diabetes patients were available for an analysis of patient characteristics, co-morbidities, biochemical parameters and drug usage. Results: Patient age at the time of diabetes diagnosis, a diagnosis of previous fracture, an alcohol related diagnosis, total cholesterol level, and the usage of antidepressants, antiepileptics and insulin all increased the odds of fracture. Low-density lipoprotein cholesterol (LDL) levels decreased the odds of fracture, where the level of 3.04-5.96 mmol/l was optimal with regard to fracture risk. Conclusion: LDL may add to the understanding of fractures in diabetes patients and it may be added to current fracture risk models in diabetes patients.
Journal of Clinical Endocrinology and Metabolism, 2014