title: Serum parathyroid hormone levels predict falls in older adults with diabetes mellitus.
abstract: 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.
authors.affiliation: Sticht Center on Aging, Wake Forest University, Winston-Salem, North Carolina, USA. dhouston@wfubmc.edu
authors.forename: Denise K
authors.initials: DK
authors.lastname: Houston
authors.forename: Ann V
authors.initials: AV
authors.lastname: Schwartz
authors.forename: Jane A
authors.initials: JA
authors.lastname: Cauley
authors.forename: Frances A
authors.initials: FA
authors.lastname: Tylavsky
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: Simonsick
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.forename: Nathalie
authors.initials: N
authors.lastname: de Rekeneire
authors.forename: Gary G
authors.initials: GG
authors.lastname: Schwartz
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Kritchevsky
mesh_terms: 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
chemical_list: C470125:PTH protein, human; D010281:Parathyroid Hormone