Endocrine Abstracts

Introduction: There are contradicting data about bone mineral density (BMD) in patients with type 2 diabetes mellitus (DM), although most studies describe increased BMD values in them. Due to this finding it is not clear how tightly bone fragility is bound with BMD in type 2 diabetic people.

Design: We provided dual-energy X-ray absorptiometry of lumbar spine and proximal femur to 46 postmenopausal women with type 2 diabetes mellitus (DM), 14 of them had bone fracture within last month. The control group included 40 non-diabetic women, 11 within a group were recently fractured. Groups were comparable in body mass index, age, duration of menopause and calcium intake. Diabetic subgroups were comparable in HbA1c level. We analysed lifestyle factors, calcium homeostasis indexes and bone turnover markers in all patients.

Results: There was a trend toward elevation of BMD in diabetic women (statistically significant for total hip). The frequency of osteoporosis and ostepenia in non-diabetic group was twice higher compared to diabetic group (correspondingly up to 45.2% vs up to 14.3% for osteoporosis and 24.1–81.8% vs 12.5–42.8% for osteopenia). In both groups with fracture (diabetic and non-diabetic) BMD was significantly lower than in groups without fracture (P<0.01 for most regions). Direct correlation with BMD were found for body mass index, lifetime weight gain and phosphorus excretion. There was inverse correlation BMD with C-terminal telopeptide of type I collagen (r=−0.24; −0.55). In diabetic group we found inverse relationships of BMD with target organs lesion (glomerular filtration rate decrease, presence of retinopathy and macroangiopathy).

Conclusion: Our data indicate that bone fragility in diabetic women is defined by BMD just the same as in non-diabetic ones despite elevation of BMD associated with type 2 DM.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.