Osteoporosis in Otherwise Healthy Patients with Type 2 Diabetes: A Prospective Gender Based Comparative Study.

BACKGROUND AND OBJECTIVE

Type 2 diabetes mellitus (T2DM) may affect bone loss differentially in adult males and postmenopausal females. We evaluated the prevalence of osteoporosis in otherwise healthy adults with T2DM.

MATERIALS AND METHODS

In a cross-sectional study, adults with T2DM, aged 50 years and above, were evaluated for bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) scan at spine and hip. T-score of ≤-2.5 was defined as osteoporosis and score -2.49 to -1.0 as osteopenia at either site. Correlation of low BMD with demographic, clinical, and laboratory parameters including serum Vitamin D and serum testosterone (in males) was evaluated.

RESULTS

In 200 patients, mean age was 64.5 ± 7.0 years and age differed significantly in males and females ( < 0.0001). Osteoporosis was present in 35.5% adults with T2DM. Significantly greater proportion of females had osteoporosis (49.5% vs. 22.3%, < 0.0001). Frequency of osteoporosis at spine (33.5%) was higher than the same at hip (13.5%). Compared to males, significantly greater proportion of females had osteoporosis and osteopenia at both spine ( < 0.0001) and hip ( < 0.0001). Among all parameters assessed, a significant positive correlation of T-score at spine and hip was seen with body mass index in both males ( = 0.287, = 0.003 at spine and = 0.421, < 0.0001 at hip) and females ( = 0.291, = 0.004 at spine and = 0.280, = 0.010 at hip). There was no association of Vitamin D deficiency (45.5% patients) with either T-score and presence of osteoporosis either at spine ( = 0.388 and = 0.177) or hip ( = 0.431 and = 0.593).

CONCLUSION

Prevalence of osteoporosis in otherwise healthy T2DM was 35.5% with greater prevalence in females than males. Body mass but not Vitamin D or testosterone has an important role in the determination of bone loss in T2DM.