Assessment of fracture risk in patients with diabetes

Abstract

Type II diabetes along with metabolic, cardiovascular and neu­rological complications, dysfunction of organs and systems leads to decreasing of bone mineral density and consequently to an increasing risk of fractures. Objective: To assess the absolute risk of fracture in patients with diabetes mellitus type II, using models of algorithms FRAX and QFracture, as well as to perform a com­parative analysis of these models. Methods: The study included 96 women with type II diabetes (average age (63,1 ± 0,8), body mass index (32,3 ± 0,49) kg/m2). According to anamnesis data of patients we evaluated absolute 10-year fracture risk using algo­rithmic systems FRAX and QFracture. Statistical data processing was carried out using MS Exel software and IBM SPSS Statistics 20. The sensitivity and specificity of methods were calculated with using of ROC-curves. Results: correlative link between the FRAX and QFracture for evaluation the 10-year risk of fracture was detected. It is established that the risk of vertebral fracture, distal forearm and humerus in patients with type II diabetes is much higher than the risk of fracture in the area of the femoral neck. Indicators of risk of fracture in studied women received with using of FRAX and QFracture exceeded those ones in popu­lations. Based on the ROC-analysis conducted for age groups 50–59, 60–69, and 70–79 years it was found high specificity and sensitivity of the methods. Conclusion: algorithmic system FRAX and QFracture have high diagnostic value, make it possible to calculate the absolute risk of fractures and to decide necessity of antiresorptive therapy. However monitoring of treatment can be made only by means of bone densitometers. Advantage of QFracture is an opportunity of fracture risk assessment in the range from 1 to 10 years.