AUTHOR=Wang Ping , Zhang Yuanfeng , Shan Ruiqi , Wu Jing , Man Sailimai , Deng Yuhan , Lv Jun , Wang Xiaona , Yin Jianchun , Ning Yi , Wang Bo , Li Liming 

TITLE=Association between trajectories of fasting plasma glucose and risk of osteoporosis in non-diabetic and diabetic populations

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.960928

DOI=10.3389/fpubh.2022.960928

ISSN=2296-2565

ABSTRACT=Introduction: Previous studies based on single measure of fasting plasma glucose (FPG) showed inconsistent conclusion about the association between FPG and osteoporosis risk. Not accounting for time-varying and cumulative average of FPG over time could bias the true relation between FPG and osteoporosis. Our study aims to investigate the association between the trajectories of FPG and osteoporosis risk for non-diabetic and diabetic populations.
Methods: A total of 18,313 participants who attended physical examinations during 2008-2018 were included. They were free of osteoporosis at their first physical examination and followed until their last physical examination before December 31, 2018. We recorded their incidence of osteoporosis and at least three FPG values during follow-up. Their longitudinal FPG trajectories were identified by latent class growth analysis model based on the changes in FPG. Multivariable logistic regression models were used to analyze the association between trajectories of FPG and osteoporosis diagnosed in follow-up physical examination in both non-diabetes and diabetes.
Results: There were 752 incident osteoporosis among 16,966 non-diabetic participants, and 57 incident osteoporosis among 1,347 diabetic participants. Among non-diabetes, the elevated-increasing FPG trajectory was negatively associated with osteoporosis risk in women (OR, 0.60; 95% CI, 0.42-0.85). Among diabetes, those whose longitudinal FPG keep in the very high level had the highest risk of osteoporosis (OR, 3.60; 95% CI, 1.62-8.01), whereas those whose FPG start with the high level and keep increasing did not exhibit significantly increased risk (OR, 1.54; 95% CI, 0.80-2.95) compared with those who keep stable moderate high level of FPG.
Conclusion: Distinct trajectories of FPG are associated with differential risk of osteoporosis in non-diabetic and diabetic population. Controlling proper FPG level in different population is necessary for osteoporosis prevention.