Introduction: Diabetes (DM) is a risk factor for fracture but women with DM have less osteoporosis by bone density (BMD) , due in part to higher body mass index (BMI) . The FRAX fracture risk calculator incorporates age, race/ethnicity, BMD, BMI, and other risk factors but not DM. Few studies have examined FRAX by DM and obesity status in different race groups. We compared predicted fracture risk in US Asian and White women by DM and obesity status.

Methods: We studied 3,640 Asian (26% DM, 24% osteoporosis, 15% obese) and 11,7White (11% DM, 12% osteoporosis, 40% obese) women aged 65-75y with BMD, excluding those with recent fracture, osteoporosis therapy, dialysis/transplant, metabolic bone disease or advanced cancer. DM (≥2 visit diagnoses + DM treatment) , obesity (BMI ≥30 kg/m2) and osteoporosis (BMD T score ≤-2.5) were obtained from electronic health data. Using the US FRAX with BMD, 10-year predicted hip fracture risk ≥3% was considered high (above treatment threshold) .

Results: The overall proportions with FRAX-Hip ≥3% were higher for those with No DM vs. DM (White 18% vs. 11%; Asian 9% vs. 7%) . However, within both DM and no DM groups, FRAX-Hip ≥3% was much higher in non-obese vs. obese women of both races (FIGURE) .

Conclusion: Predicted hip fracture risk varies by DM and especially by obesity status in White and Asian women. Future studies should examine the accuracy of FRAX for actual hip fracture risk in these subgroups.


J.C.Lo: None. M.Chandra: None. N.P.Gordon: None. C.Lee: None.


National Institute on Aging, National Institutes of Health (AG069992)

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