Influence of diabetes on peripheral bone mineral density in men: a controlled study

Abstract

The aims of the study were to (1) compare peripheral bone mineral density (BMD) in men with diabetes to peripheral BMD in non-diabetic men, and (2) explore factors which may predict BMD in diabetic men. Ninety men with type 2 diabetes and 35 men with type 1 diabetes were randomly selected for participation via a computerised database. Fifty healthy males were also recruited. All patients had peripheral BMD measured by dual energy Xray absorptiometry (DEXA) at the non-dominant distal radius. Information on a number of clinical parameters was obtained by direct questioning, and from patient case notes. The mean age (95% confidence interval (CI)) of the type 1 diabetic group, type 2 diabetic group and control group were, respectively: 49.3 years (44.6-53.9), 62.8 years (60.7-64.8) and 38.5 (34.9-42.1) years. Median (95% CI) Z-scores for the three groups were: -0.18 (-0.68 to +0.32), +0.19 (-0.14 to +0.49) and -0.02 (-0.4 to +0.31), respectively (p=not significant). Only body mass index (BMI) was correlated with BMD in the type 1 diabetic group, and only BMI and age were correlated with BMD in type 2 diabetics. There was no correlation between BMD and glycosylated haemoglobin concentration (HbA(1)c), disease duration or presence of microvascular or macrovascular complications in either of the diabetic groups. We did not find any significant difference in peripheral BMD between patients with type 1 diabetes, type 2 diabetes and controls.

Bone mineral density and hip structural analysis in type 1 diabetic men

“…However, some studies reported normal hip BMD (22,23), and normal (24) or even increased spine BMD (25). Nevertheless, there is agreement that approximately 40-50% diabetic patients have decreased BMD and this decrease is independent of age, diabetes duration, presence of chronic microvascular complications, and the onset of diabetes (5,6,26), similar to our results. Bone loss was found even in children, at the time of diagnosis (6,27).…”

Relationship between oxidative stress and diabetic osteopenia in premenopausal rats

“…Therefore, our results once again support the association between diabetes, increased lipid peroxidation and decreased GSH content in the development of bone histomorphometry and biomechanical changes in a premenopausal diabetic model. DXA has been the predominant technology used to evaluate trabecular bone mass loss both in animal models (Fukuharu et al, 2000;Duarte et al, 2005) and in diabetic patients (Bridges et al, 2005;Léger et al, 2006). In the present study, our results showed a significant decrease in femoral diabetic BMD values, measured by DXA, confirming that the evolution time of diabetes has a deleterious effect on the metabolically active trabecular bone of premenopausal rats.…”

MECHANISMS IN ENDOCRINOLOGY: Mechanisms and evaluation of bone fragility in type 1 diabetes mellitus

“…Most (27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44), although not all (45,46,47,48,49), studies report a significant decrease in BMD at either the spine, hip or total body. The magnitude of the decrease in BMD varied quite markedly from 8 to 67%, and large gender differences appear to be present, with many studies documenting changes in BMD in either males or females only.…”

“…A few studies (45,51,52,53,54,55,56,57) have employed peripheral quantitative computer tomography (pQCT) or peripheral DXA (pDXA) to study the BMD of the distal forearm or tibia in T1DM. Some (45,56) have reported no difference in the BMD between diabetics and controls, whereas others (51,52,53,54,55,57) have documented a decrease in either trabecular and/or cortical BMD at these sites.…”

“…Some (45,56) have reported no difference in the BMD between diabetics and controls, whereas others (51,52,53,54,55,57) have documented a decrease in either trabecular and/or cortical BMD at these sites. F/M, female/male; Duration, duration of diabetes in years; Site, skeletal site demonstrating a decreased bone mineral density (BMD); MVC, correlation between BMD and diabetic microvascular complication(s); GC, correlation between BMD and glycaemic control (usually the mean HbA1c); NR, not reported; H, hip; S, spine; TB, total body; Hip*, only site measured; Spine*, only site measured.…”