Abstract
Introduction: Diabetes mellitus (DM) impairs bone strength resulting in an increased risk of fractures. This study was designed to determine the association between bone mineral density (BMD) and vertebral fractures among a selected group of patients with Type 2 diabetes mellitus. Methods: This cross-sectional study included patients with diabetes, selected from clinic attendees at Teaching Hospital Karapitiya. Serum creatinine, urine microalbumin to creatinine ratio and a lateral radiograph of the thoraco-lumbar spine were done in all patients. Those who were detected to have vertebral fracture/s underwent bone densitometry. BMD was also measured in a group of patients selected from the rest of the group who did not have vertebral fractures and another group of healthy individuals selected from the same community. They were matched for the age and gender. Results: In patients with diabetes (n=160, females 110), the mean (SD) age and the duration of the disease were 62 (10) years and 10 (3) years, respectively. Of patients with diabetes screened, 20 had vertebral fractures (12.5% prevalence). Compared to healthy controls, patients with diabetes without vertebral fractures had significantly low BMDs in the proximal femur but comparatively higher BMD in the total spine. BMDs measured in the total spine and proximal femur were not different between patients with DM vertebral fractures and without vertebral fractures. Conclusions: Our data indicate a 12.5% prevalence of vertebral fracture among patients with DM. Although patients with diabetes in general had lower BMDs in most of the regions examined, there was no significant difference in regional BMDs between those with fractures and without fractures.
Highlights
Diabetes mellitus (DM) impairs bone strength resulting in an increased risk of fractures
Diabetes and fragility fractures will be more prevalent in the future but an exponential rise is expected in certain regions such as Asia
There were 160 (110 females) patients included in the study and the mean (SD) age and the duration of the disease were 62 [10] years and 10 [3] years, respectively
Summary
Diabetes mellitus (DM) impairs bone strength resulting in an increased risk of fractures. This study was designed to determine the association between bone mineral density (BMD) and vertebral fractures among a selected group of patients with Type 2 diabetes mellitus. Diabetes mellitus (DM) and fragility fractures are associated with increased morbidity, mortality and health-care cost, they have become major public health issues, globally. While Vestergaard, et al, and Yammamoto, et al, found an increased prevalence of vertebral fracture (VF) among adult patients with DM, Gerdhem, et al, and Schwartz, et al, found no such association [1]. DM could influence bone strength in many ways Factors such as hyperglycaemia, hypercalciuria, elevated levels of cytokines and impaired renal function seen in DM could reduce bone strength [2]. Microvascular complications of DM could reduce the bone strength resulting in fractures
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