Osteoporosis in otherwise healthy patients with type 2 diabetes: A prospective gender based comparative study

Abstract

Background and Objective:Type 2 diabetes mellitus (T2DM) may affect bone loss differentially in adult males and postmenopausal females. We evaluated the prevalence of osteoporosis in otherwise healthy adults with T2DM.Materials and Methods:In a cross-sectional study, adults with T2DM, aged 50 years and above, were evaluated for bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) scan at spine and hip. T-score of ≤−2.5 was defined as osteoporosis and score −2.49 to −1.0 as osteopenia at either site. Correlation of low BMD with demographic, clinical, and laboratory parameters including serum Vitamin D and serum testosterone (in males) was evaluated.Results:In 200 patients, mean age was 64.5 ± 7.0 years and age differed significantly in males and females (P < 0.0001). Osteoporosis was present in 35.5% adults with T2DM. Significantly greater proportion of females had osteoporosis (49.5% vs. 22.3%, P < 0.0001). Frequency of osteoporosis at spine (33.5%) was higher than the same at hip (13.5%). Compared to males, significantly greater proportion of females had osteoporosis and osteopenia at both spine (P < 0.0001) and hip (P < 0.0001). Among all parameters assessed, a significant positive correlation of T-score at spine and hip was seen with body mass index in both males (r = 0.287, P = 0.003 at spine and r = 0.421, P < 0.0001 at hip) and females (r = 0.291, P = 0.004 at spine and r = 0.280, P = 0.010 at hip). There was no association of Vitamin D deficiency (45.5% patients) with either T-score and presence of osteoporosis either at spine (P = 0.388 and P = 0.177) or hip (P = 0.431 and P = 0.593).Conclusion:Prevalence of osteoporosis in otherwise healthy T2DM was 35.5% with greater prevalence in females than males. Body mass but not Vitamin D or testosterone has an important role in the determination of bone loss in T2DM.

Osteoporosis Prevalence and Correlates in Uncomplicated Type 2 Diabetes Mellitus

“…Our study had relatively more osteopenia (47%) patients than osteoporosis (39%) which is in agreement with the observation of Sharma et al 6 who also had higher number of osteopenia (51.5%) patients than osteoporosis (35.5%). They had an overall prevalence of osteopenia and osteoporosis close to ours (87% vs 86% in our study).…”

“…One of the reasons could be primarily the present study had only few cases with T2DM duration >10 years (mean duration of T2DM 6.21 years). Compared to our study, Prakash et al [6,5] had 35.4% patients with T2DM duration >10 years and also included patients with T2DM duration >15 years. Our study findings are in agreement with the observations of Mobini et al [14] who also did not find a significant association osteoporosis and duration of diabetes.…”

“…These findings are in agreement with the observations of Prakash et al [10] who also found both prevalence of osteoporosis to be higher at Lumbar spine (39.6%) as compared to hip (20.8%). Sharma et al [6] also observed that prevalence of osteoporosis at spine was 33.5% whereas at hip it was 13.5%. A similar observation was also made by Kamalnathan et al [8] who reported mean Z-scores for BMD at spine to be lower as compared to that at hip.…”

Prevalence and predictors of low bone mineral density in treatment-naive HIV-infected patients and its correlation with CD4 cell counts

“…Malnutrition is also very common, with predominantly high carbohydrate diet and low calcium and protein intake. HIV/AIDS is a disease of low-income group in India, and other factors such as loss of employment and depression may contribute to osteoporosis, the prevalence of which was found to be even higher than that reported in patients with rheumatoid arthritis (15%)[ 11 ] or diabetes mellitus (15%)[ 12 ]. We found a significant association of low BMD with longer duration of disease.…”

High Body Mass Index and Triglycerides Help Protect against Osteoporosis in Patients with Type 2 Diabetes Mellitus

“…A cross-sectional study including 200 subjects in India found that the prevalence of OP in patients with T2DM is about 20-35% [ 6 ]. The risk of hip fracture is 2.5-fold higher than general population in patients with T2DM [ 7 ].…”