Osteoporosis and osteopenia in older Emirati men with type 2 diabetes mellitus

Raya A Almazrouei; Fatima M Alkaabi; Heba El Gayar; Nader Lessan; Maha T Barakat

doi:10.1530/endoabs.41.EP100

Introduction: Osteoporosis is an important cause of morbidity and mortality in older men, but the extent of the problem amongst Emiratis has not been previously reported. A screening programme has been in place for older men in a large diabetes centre in the UAE, allowing patients over age 70 to have DEXA scans; we have investigated the prevalence of osteoporosis and osteopenia in this population.

Methods: Data on 179 consecutive patients with type 2 diabetes over age 70 with DEXA scan reports were retrieved and analysed. T-score at lumbar spine, femoral neck and hip were recorded. Relevant demographic and phenotypic data and laboratory investigations at or closest the time of DEXA and comorbidities list were extracted from individual computerized patient records. Stata13.0 was used for data analysis.

Results: Table 1 summarizes results based on the diagnosis of osteoporosis or osteopenia at any of the five sites studied. Osteoporosis at lumbar spine and left femoral neck was noted in 32.2 and 19.5% of the patients respectively. Significant predictors of bone density (univariate regression analysis) included age (odds ratio-OR 1.14, P=0.02), weight (OR 0.96, P=0.02) and height (OR 0.87, P<0.001). In multivariate analysis including age, weight, height and eGFR, only height (OR 0.88, P=0.005) remained a predictor with significance. There was 82.4% osteoporosis range T-scores concordance between the right and left femoral neck levels.

Table 1.
	Osteoporosis n (%)	Osteopenia n (%)	Normal n (%)	P value
Number and (%)	83 (46.4%)	73 (40.8%)	23 (12.9%)	–
Non-smoker	64 (77%)	53 (73%)	17 (74%)	0.96
Hypothyrodism	2 (2.4%)	5 (6.9%)	1 (4.4%)	0.41
Hypertension	76 (91.6%)	67 (91.8%)	22 (95.7%)	0.80
CVD	25 (30.1%)	16 (21.9%)	7 (30.4%)	0.47
Insulin therapy	19 (22.9%)	25 (34.3%)	10 (43.3%)	0.1
OHAs	74 (89.2%)	65 (89%)	21 (91.3%)	0.95
Weight (kg)	69.8 (±14.3)	76.4 (±13.2)	80.2 (±10.3)	<0.001
Height (cm)	162.4 (±7.2)	164.4 (±5.6)	169.04 (±6.4)	<0.001
eGFR ml/min per 1.73 m²	66.7 (±33.3)	74.4 (±24.9)	80.3 (±16.3)	0.07
HbA1c (%)	7.1 (±1.3)	7.4 (±1.5)	6.9 (±0.9)	0.22
Serum calcium (mmol/l)	2.3 (±0.1)	2.3 (±0.1)	2.3 (±0.1)	0.31
Strgm vitamin D (nmol/l)	76.9 (±27.4)	76.4 (±24.1)	82.6 (±32.9)	0.6
TSH level (milli IU/l)	2.7 (±1.4)	2.6 (±1.5)	2.7 (±1.2)	0.94
DM duration (years)	12.5 (±8.9)	16.2 (±10.2)	15.3 (±10.9)	0.05^a
CVD, cerebrovascular disease; OHAs, oral hypoglycemic agents; testing based on one-way ANOVA and χ² test.
^aDM duration not normally distributed, median test P value=0.25.

Conclusion: Compared to European reports, prevalence of osteoporosis in this population of Emirati men with type 2 diabetes is much higher. Specific local factors such as relative inactivity in old age and lack of sun exposure may be responsible for such high prevalence figures and need to be further investigated in a larger group of patients.

Endocrine Abstracts

EP100