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The evaluation of densitometrical findings in diabetes mellitus typ 2 patients: our experiences

AIM: To determine correlation between glycemic control and osteoporosis in diabetes mellitus type 2 patients (DM type 2). Methods: The subjects were divided into one group consisting of 60 DM type 2 patients and control group made up of 27 nondiabetic subjects randomized according to their age and gender. The bone mineral density was measured by DXA densitometry at the lumbar spine and in the hip- neck region. Osteoporosis was defined as T-score: normal (T<)1.0), osteopenia ()1.0<t)2.5 SD). Results: Distribution of results in DM type 2 patients suggest that osteopenia is most frequent among male participants (60%), with more than half the total number of instances located at the lumbar spine (55.56%) ; female osteopenia on the other hand, was mostly found at the neck of the hip. The most frequent finding in women (51.87%) were cases of osteoporosis, with over two-thirds of such cases being found within the lumbar spine. The densitometrical result of normal was almost equally divided between patients above and below the age of 60 years in both groups of participans (OR=1.07 vs. OR=0.94) but osteopenia was more frequent within older patients in both groups (OR=6). Osteoporosis was more common among older diabetic women than among controls (OR=2.6). There was no significantly established correlation between body mass index (BMI) and densitometrical results neither within diabetic patients (p=0.631) nor controls (p=0.343). Elevated values of glycosylated haemoglobin (HbA1C) ‡6.5% were found in 80.95% of diabetic patients, with 30.95% of them displaying severely elevated levels (‡11.5%). Osteoporosis was the most frequent finding (47.6%) in diabetic women with elevated HbA1C. According to the results, significant positive correlation was established between HbA1C and alternation of bone mineral density in all DM type 2 patients (r=0.52, p£0.05). However, greater risk of osteoporotic fractures was established in diabetic patients (RR=1.36) and especially in diabetic women (RR=1.75). Conclusion: Badly controlled glycemia is an important factor, and accelerates the reduction of bone mineral density according to age, gender and obesity but also independently of those factors. This is our preliminary exploration which will be continued with a larger number of participants.

osteoporosis, diabetes mellitus

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