Endocrine Abstracts

Introduction: Diabetes mellitus is associated with an increased risk of osteoporotic fractures, which leads to an increased risk of disability and frailty.

Aims: To assess the prevalence of frailty in type 2 diabetes and to analyze the relationship with bone mineral density (BMD) and Trabecular Bone Score (TBS), fracture risk and prevalent fractures.

Methods: We carried out a cross-sectional study of 75 diabetic patients (65±7 years, 55.3% males). We collect data on clinical history, measured BMD and obtened trabecular bone score (TBS) by dual-energy X-ray absorptiometry (DXA) and software TBS InSight^® respectively. We also estimated 10-year fractures risk using FRAX, FRAX adjusted with TBS and QFracture score. Finally, we conducted a validated fragility survey (Frail Scale).

Results: 20% (n: 15) were considered fragile, 8% (n: 6) had densitometric osteoporosis and 13% (n: 10) had a history of fragility fractures. Frail scale was not related to the values of BMD or TBS. However, we found significant differences between fragile and non-fragile diabetic patients in the risk of major osteoporotic fracture (MOF) or hip fracture (HF) at 10 years in the FRAX score (MOF:: 4.7 4.2 vs 2.7 2.1 P=0.025), FRAX score adjusted with TBS (MOF: 6.9 5.1 vs 3.8 3.1 P=0.015; CF: 2 2.7 vs 0.7 1 P=0.009) and QFracture score (MOF: 8.9 6.8 vs 4.9 3.8 P=0.012; CF: 4.6 4.8 vs 2.3 2.3 P=0.018). There were more patients with history of fractures in the group of fragile patients compared to non-fragile patients (35.7% vs. 8.2% P=0.006).

Conclussion: Fragility index in type 2 diabetes mellitus is useful for identification of patients with risk of osteoporotic fracture or prevalent fracture.