Age-related bone mineral density, osteoporosis rate and risk of vertebral fracture in mainland Chinese women with type 2 diabetes mellitus

Abstract

Few data are available regarding bone mineral density (BMD) and the risk of vertebral fracture among mainland Chinese women with type 2 diabetes mellitus (T2DM). A decrease in the bone projective area (BPA) can be an indirect marker reflecting compressed vertebral fracture. We investigated age-related BMD, BPA, and the prevalence of osteoporosis in women with T2DM in mainland China. BMD and BPA of the posteroanterior lumbar spine (L1-L4) and hip were measured by dual-energy X-ray absorptiometry in 1253 women with T2DM and 1194 control subjects without diabetes aged 40-80 yr. BMD of the lumbar spine and hip decreased with age. BMD of the lumbar spine was higher in T2DM than controls (p<0.05-0.001), as was BPA at some vertebral bodies (p<0.05-0.001), whereas no significant intergroup differences in BPA were observed at the hip. The prevalence of osteoporosis in the women with T2DM increased with age: 0-2.58% at age 40-49 yr, 6.94-28.4% at age 50-59 yr, 32.7-76.7% at age 70-80 yr, with the range reflecting differences between skeletal sites. In subjects over 60 yr, the rates of osteoporosis at posteroanterior spine were significantly lower in T2DM patients than in controls (p<0.05-0.001). In conclusion, women with T2DM had higher BMD and lower risk of osteoporosis. Higher BPA of the vertebrae indicated that women with T2DM in mainland China would have a lower risk of vertebral fracture than non-diabetic women.

Association between bone mineral density and type 2 diabetes mellitus: a meta-analysis of observational studies

“…Since May 2010 about 134 articles have been published on the topic of which we could identify two that would have met our inclusion criteria [55, 56]. These were studies based on Chinese populations showing opposite results with one concluding type 2 diabetics had higher BMD [55] while the other [56] concluded diabetics had lower BMD and higher risk of osteoporosis.…”

“…These were studies based on Chinese populations showing opposite results with one concluding type 2 diabetics had higher BMD [55] while the other [56] concluded diabetics had lower BMD and higher risk of osteoporosis.…”

Epidemiology of fractures in type 2 diabetes

“…All but one of the studies was conducted in Western countries, characterized by a high prevalence of obesity and overweight in patients with type 2 diabetes. Studies in East Asian countries, with a lower prevalence of obesity in diabetic patients, have provided inconsistent results, reporting lower [47][48][49], similar [50][51][52][53] and higher [50][51][52]54,55] BMD at the hip and/ or spine in those with diabetes. Two studies in China have assessed the relationship between DM and BMD, stratified by BMI.…”

Effect of transplantation of marrow mesenchymal stem cells transfected with insulin-like growth factor-1 gene on fracture healing of rats with diabetes

“…However, fracture healing is a process where multiple cells and factors participate. Diabetic fracture healing is more complex and a conundrum requiring urgent solution (19)(20).…”