J Clin Endocrinol Metab. 2023 Oct 18:dgad601. doi: 10.1210/clinem/dgad601. Online ahead of print.
ABSTRACT
CONTEXT: Although physical activity (PA) is recognized to reduce fracture risk, whether its benefits differ according to the glycemic status remains unknown.
OBJECTIVES: We investigated the effect of PA on incident hip fracture (HF) according to the glycemic status.
METHODS: We studied 3,723,097 patients over 50 without type 1 diabetes mellitus (DM) or past fractures. Hip fracture risks were calculated using Cox proportional hazard regression. Participants were categorized by glycemic status into five groups: normal glucose tolerance, impaired fasting glucose, new-onset type 2 DM, type 2 DM <5 years, and type 2 DM ≥5 years. PA was evaluated using the Korean adaptation of the International Physical Activity Questionnaire Short Form.
RESULTS: The highest HF risk were associated with the lowest PA level (<500 metabolic equivalent task (MET)-min/week). While similar risks emerged across MET 500-1000, 1000-1500, and >1500 categories, the relationship showed variations in different glycemic status groups. Exceptions were particularly noted in women with normoglycemia. However, a consistent inverse pattern, with few exceptions, was observed in both men and women with type 2 DM ≥5 years. Furthermore, the benefit of physical activity in the prevention of hip fractures was most evident in participants with type 2 DM ≥5 years. Compared to the reference group (lowest physical activity level <500 MET-min/week within type 2 DM ≥5 years), the adjusted hazard ratios were 0.74 [0.62-0.88] in men and 0.74 [0.62-0.89] in women, suggesting a significant reduction in risk.
CONCLUSION: Higher PA levels are associated with a lower risk of HF. This protective effect of PA on fracture risk is greatest in patients with DM, particularly in those with DM ≥5 years.
PMID:37850407 | DOI:10.1210/clinem/dgad601
