From the Department of Internal Medicine, College of Medicine, Taibah University, Al Madinah Al Munawarah, Kingdom of Saudi Arabia.
Saudi Med J. 2022 Jul;43(7):700-707. doi: 10.15537/smj.2022.43.7.20220144.
To compare the bone mineral density and the fracture risks in Saudi women with and without type 2 diabetes mellitus (T2DM).
This cross-sectional study was carried out at Taibah Early Diagnostic Center, Al Madinah Al Munawarah, Saudi Arabia. A total of 465 women with and without T2DM aged ≥40 years who visited the center for a dual-energy X-ray absorptiometry scan between December 2020 and July 2021 were randomly selected. The 10-year probabilities of major osteoporotic fracture (MOF) and hip fracture (HF) were calculated using the Abu Dhabi Fracture Risk Assessment Tool (FRAX) with and without adjustment for T2DM. The adjustment was made by setting rheumatoid arthritis as the equivalent risk for T2DM in the FRAX. Bone mineral density values and the FRAX scores were compared between women with T2DM and non-diabetes.
Of 465 women, 214 had T2DM, and 251 were non-diabetics. The mean age of women was 59.42±7.9 years. There were no significant differences in mean age, menopausal status, height, weight, and body mass index between T2DM and non-diabetic women. Bone mineral density values and the unadjusted FRAX scores were comparable between the 2 groups. However, after adjusting FRAX for T2DM, the FRAX for MOF and HF became significantly higher in T2DM women (=0.000 and =0.004).
In Saudi women with T2DM, unadjusted FRAX underestimated the risk of MOF and HF. Type 2 diabetes mellitus should be included as one of the clinical risk factors for fracture in future versions of the FRAX score.
比较有和无 2 型糖尿病（T2DM）的沙特女性的骨密度和骨折风险。
本横断面研究在沙特阿拉伯麦地那的 Taibah 早期诊断中心进行。共随机选择了 2020 年 12 月至 2021 年 7 月期间因双能 X 线吸收法扫描而到中心就诊的 465 名年龄≥40 岁的有和无 T2DM 的女性。使用阿布扎比骨折风险评估工具（FRAX）计算 10 年主要骨质疏松性骨折（MOF）和髋部骨折（HF）的概率，同时考虑和不考虑 T2DM 进行调整。在 FRAX 中，将类风湿关节炎设定为 T2DM 的等效风险来进行调整。比较 T2DM 女性和非糖尿病女性的骨密度值和 FRAX 评分。
465 名女性中，214 名患有 T2DM，251 名非糖尿病患者。女性的平均年龄为 59.42±7.9 岁。T2DM 组和非糖尿病组的平均年龄、绝经状态、身高、体重和体重指数无显著差异。两组间的骨密度值和未调整的 FRAX 评分无显著差异。然而，在调整 FRAX 以考虑 T2DM 后，T2DM 女性的 MOF 和 HF 的 FRAX 显著更高（=0.000 和=0.004）。
在有 T2DM 的沙特女性中，未调整的 FRAX 低估了 MOF 和 HF 的风险。在未来的 FRAX 评分版本中，应将 2 型糖尿病纳入骨折的临床危险因素之一。
