Association between bone mineral density and vertebral fractures among patients with diabetes attending Teaching Hospital Karapitiya

Abstract

Introduction: Diabetes mellitus (DM) impairs bone strength resulting in an increased risk of fractures. This study was designed to determine the association between bone mineral density (BMD) and vertebral fractures among a selected group of patients with Type 2 diabetes mellitus. Methods: This cross-sectional study included patients with diabetes, selected from clinic attendees at Teaching Hospital Karapitiya. Serum creatinine, urine microalbumin to creatinine ratio and a lateral radiograph of the thoraco-lumbar spine were done in all patients. Those who were detected to have vertebral fracture/s underwent bone densitometry. BMD was also measured in a group of patients selected from the rest of the group who did not have vertebral fractures and another group of healthy individuals selected from the same community. They were matched for the age and gender. Results: In patients with diabetes (n=160, females 110), the mean (SD) age and the duration of the disease were 62 (10) years and 10 (3) years, respectively. Of patients with diabetes screened, 20 had vertebral fractures (12.5% prevalence). Compared to healthy controls, patients with diabetes without vertebral fractures had significantly low BMDs in the proximal femur but comparatively higher BMD in the total spine. BMDs measured in the total spine and proximal femur were not different between patients with DM vertebral fractures and without vertebral fractures. Conclusions: Our data indicate a 12.5% prevalence of vertebral fracture among patients with DM. Although patients with diabetes in general had lower BMDs in most of the regions examined, there was no significant difference in regional BMDs between those with fractures and without fractures.