Serum parathyroid hormone levels predict falls in older adults with diabetes mellitus.
OBJECTIVE
To examine the association between serum parathyroid hormone (PTH) levels and incident falls in older adults with diabetes mellitus.


METHODS
Longitudinal analysis of incident falls over 1 year in a substudy of participants with diabetes mellitus in the Health, Aging and Body Composition Study.


METHODS
Pittsburgh, Pennsylvania, and Memphis, Tennessee.


METHODS
Well-functioning, community-dwelling black and white adults aged 70 to 79 with diabetes mellitus (N=472).


METHODS
Measured baseline serum PTH. Self-report of falls over the subsequent 12 months. Baseline physical performance and self-reported demographic, behavioral, and health status measures including kidney function, chronic conditions, and medication use.


RESULTS
One-third (30.3%) of participants reported falling over 1 year of follow-up. Mean baseline serum PTH was 53.5+/-30.0 pg/mL in nonfallers and 62.6+/-46.2 pg/mL in fallers (P=.01). For every 1 standard deviation (36 pg/mL) increment in baseline serum PTH, there was approximately a 30% greater likelihood of reporting a fall in the subsequent year, after adjusting for age, sex, race, field center, alcohol consumption, body mass index, physical activity, and winter or spring season (adjusted odds ratio (aOR)=1.30, 95% confidence interval (CI)=1.06-1.59). Further adjustment for kidney function, chronic conditions, medication and supplement use, and physical performance attenuated the association slightly (aOR=1.26, 95% CI=1.01-1.58). A trend remained after additional adjustment for reported falls in the previous year.


CONCLUSIONS
Higher serum PTH was associated with incident falls in older, well-functioning men and women with diabetes mellitus. Further investigation aimed at understanding the underlying mechanism for the association between serum PTH and falls is needed.
Houston
Denise K
DK
Sticht Center on Aging, Wake Forest University, Winston-Salem, North Carolina, USA. dhouston@wfubmc.edu
Schwartz
Ann V
AV
Cauley
Jane A
JA
Tylavsky
Frances A
FA
Simonsick
Eleanor M
EM
Harris
Tamara B
TB
de Rekeneire
Nathalie
N
Schwartz
Gary G
GG
Kritchevsky
Stephen B
SB
D000058:Accidental Falls; D000368:Aged; D003920:Diabetes Mellitus / Q000097:blood* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood*; D010807:Physical Endurance / Q000502:physiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors
C470125:PTH protein, human; D010281:Parathyroid Hormone