Prevalence and determinants of osteoporosis in patients with type 1 and type 2 diabetes mellitus

BMC Endocrine Disorders

Jochen G Schneider²  Peter Nawroth³  Christa Scheidt-Nave⁴  Thomas Bruckner¹  Sonja Grobholz³  Gudrun Leidig-Bruckner³ 

[1] Institute for Medical Biometry and Informatics, University of Heidelberg, INF 305, Heidelberg 69120, Germany;Luxembourg Centre for Systems Biomedicine (LCSB), Université du Luxembourg & Internal Medicine II, Saarland University Medical Center at Homburg/Saar, Kirrbergerstrasse 100, Homburg/Saar 66421, Germany;Department of Internal Medicine, Endocrinology and Metabolism, University of Heidelberg, INF 410, Heidelberg 69120, Germany;Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Straße 62-66, Berlin 12101, Germany

关键词: Vascular complications;    Osteoporosis;    Fractures;    Diabetes mellitus;    Bone mineral density;   

Others  :  864935
DOI  :  10.1186/1472-6823-14-33

 received in 2013-11-17, accepted in 2014-04-08,  发布年份 2014

【 摘 要 】

Background

Increased risk of osteoporosis and its clinical significance in patients with diabetes is controversial. We analyze osteoporosis prevalence and determinants of bone mineral density (BMD) in patients with type 1 and 2 diabetes.

Methods

Three hundred and ninety-eight consecutive diabetic patients from a single outpatient clinic received a standardized questionnaire on osteoporosis risk factors, and were evaluated for diabetes-related complications, HbA1c levels, and lumbar spine (LS) and femoral neck (FN) BMD. Of these, 139 (71 men, 68 women) type 1 and 243 (115 men, 128 women) type 2 diabetes patients were included in the study. BMD (T-scores and values adjusted for age, BMI and duration of disease) was compared between patient groups and between patients with type 2 diabetes and population-based controls (255 men, 249 women).

Results

For both genders, adjusted BMD was not different between the type 1 and type 2 diabetes groups but was higher in the type 2 group compared with controls (p < 0.0001). Osteoporosis prevalence (BMD T-score < −2.5 SD) at FN and LS was equivalent in the type 1 and type 2 diabetes groups, but lower in type 2 patients compared with controls (FN: 13.0% vs 21.2%, LS: 6.1% vs 14.9% men; FN: 21.9% vs 32.1%, LS: 9.4% vs 26.9% women). Osteoporosis prevalence was higher at FN-BMD than at LS-BMD. BMD was positively correlated with BMI and negatively correlated with age, but not correlated with diabetes-specific parameters (therapy, HbBA1c, micro- and macrovascular complications) in all subgroups. Fragility fracture prevalence was low (5.2%) and not different between diabetes groups. Fracture patients had lower BMDs compared with those without fractures; however, BMD T-score was above −2.5 SD in most patients.

Conclusions

Diabetes-specific parameters did not predict BMD. Fracture occurrence was similar in both diabetes groups and related to lower BMD, but seems unrelated to the threshold T-score, <−2.5 SD. These results suggest that osteoporosis, and related fractures, is a clinically significant and commonly underestimated problem in diabetes patients.

【 授权许可】

   
2014 Leidig-Bruckner et al.; licensee BioMed Central Ltd.

【 图 表 】

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