Endocrine Abstracts

According to numerous studies, type 2 diabetes mellitus (T2DM) is associated with an increased risk of low traumatic non-vertebral fracture. There are a limited number of studies which evaluate lateral vertebral X-Rays in order to diagnose vertebral fractures in patients with T2DM. The goal of our study was to investigate the difference in vertebral fracture rate registered on lateral X-Ray between subjects with T2DM and a control group being under observation in the same outpatient clinic.

Materials and Methods: We enrolled 501 subjects from a single outpatient clinic in Moscow. All T2DM patients (n=251) and non-DM controls (n=250) had lateral spine X-Rays at the Th4-L5. All available vertebrae were graded by an experienced radiologist, vertebral fracture was confirmed if visual inspection perceived at least a 20% reduction in vertebral height (anterior, posterior or middle), as described by Genant et al.

Results: Among enrolled subjects 92 (18.4%) were male and 409 (81.6%) were female; the mean age was 64 (95% CI 47–91) years. Vertebral fractures were found in 78 subjects (15.5%) and 108 individuals (21.5%) reported low-traumatic non-vertebral fractures, in total low traumatic fracture was registered in 165 (32.9%) cases out of 501 enrolled. In total among subjects with T2DM (n=251) vertebral fracture was present in 36 cases, in subjects without T2DM (n=250) in 42 cases (P=0.408). There was no statistically significant difference in the number of non-vertebral fractures (62 with T2DM and 42 in the control group) (P=0.062). It seems that among women with T2DM non-vertebral fractures occurred slightly more commonly (n=52) vs the group without T2DM (n=42) P=0.031. Subjects with T2DM (65 male and 186 female) had BMI – 30.5 (27.1–34.6) kg/m². The mean duration of T2DM was 8 (4–13) years. They suffered from macrovascular complications in 54.8% of cases; polyneuropathy −54.8%; retinopathy −25.6%; nephropathy −15.2%. Treatment with insulin was prescribed in 82 cases (32.8%). The glucose control was acceptable with HbA1c – 7.4% (6.6%–8.3%) in this group of outpatients with T2DM

Conclusion: Outpatients with T2DM with well-compensated diabetes do not demonstrate an increased risk of vertebral fracture as assessed by lateral X-Ray.