Department of Medicine, Surgery and Neuroscience, University of Siena, Policlinico Le Scotte, Viale Bracci 2, 53100, Siena, Italy.
Aging Clin Exp Res. 2022 Jan;34(1):121-127. doi: 10.1007/s40520-021-01889-w. Epub 2021 May 29.
Patients with type 2 diabetes (T2DM) have an increased or normal BMD; however fragility fractures represent one of the most important complications of T2DM.
This study aimed to evaluate whether the use of the Radiofrequency Echographic multi spectrometry (REMS) technique may improve the identification of osteoporosis in T2DM patients.
In a cohort of 90 consecutive postmenopausal elderly (70.5 ± 7.6 years) women with T2DM and in 90 healthy controls we measured BMD at the lumbar spine (LS-BMD), at femoral neck (FN-BMD) and total hip (TH-BMD) using a dual-energy X-ray absorptiometry device; moreover, REMS scans were also carried out at the same axial sites.
DXA measurements were all higher in T2DM than in non-T2DM women; instead, all REMS measurements were lower in T2DM than in non T2DM women. Moreover, the percentage of T2DM women classified as "osteoporotic", on the basis of BMD by REMS was markedly higher with respect to those classified by DXA (47.0% vs 28.0%, respectively). On the contrary, the percentage of T2DM women classified as osteopenic or normal by DXA was higher with respect to that by REMS (48.8% and 23.2% vs 38.6% and 14.5%, respectively). T2DM women with fragility fractures presented lower values of both BMD-LS by DXA and BMD-LS by REMS with respect to those without fractures; however, the difference was significant only for BMD-LS by REMS (p < 0.05).
Our data suggest that REMS technology may represent a useful approach to enhance the diagnosis of osteoporosis in patients with T2DM.
2 型糖尿病(T2DM)患者的骨密度(BMD)可能增加或正常;然而,脆性骨折是 T2DM 的最重要并发症之一。
本研究旨在评估射频超声多谱(REMS)技术的应用是否可以改善 T2DM 患者骨质疏松症的诊断。
在 90 例连续绝经后老年(70.5±7.6 岁)T2DM 患者和 90 例健康对照组中,我们使用双能 X 射线吸收仪测量腰椎(LS-BMD)、股骨颈(FN-BMD)和全髋(TH-BMD)的 BMD;此外,还在同一轴向部位进行了 REMS 扫描。
T2DM 患者的 DXA 测量值均高于非 T2DM 患者;相反,T2DM 患者的所有 REMS 测量值均低于非 T2DM 患者。此外,根据 REMS 的 BMD 将 T2DM 患者分类为“骨质疏松症”的比例明显高于根据 DXA 分类的患者(分别为 47.0%和 28.0%)。相反,根据 DXA 将 T2DM 患者分类为骨质疏松或正常的比例高于根据 REMS 分类的患者(分别为 48.8%和 23.2%,以及 38.6%和 14.5%)。脆性骨折的 T2DM 患者的 DXA 测量的 LS-BMD 和 REMS 测量的 LS-BMD 值均低于无骨折患者;然而,仅 REMS 测量的 LS-BMD 差异具有统计学意义(p<0.05)。
我们的数据表明,REMS 技术可能是一种有用的方法,可以增强 T2DM 患者骨质疏松症的诊断。