Abstract
This study aimed to explore the risk factors attributed to osteoporosis in newly type 2 diabetes mellitus (T2DM) patients. This study aimed to recruit 244 T2DM patients and 218 non-diabetic controls. We collected demographic characteristics, medical history, bone mineral density and biomarkers including bone specific alkaline phosphatase (BALP), osteocalcin, N-terminal peptide of type I procollagen (P1NP), tartrate-resistant acid phosphatase 5b (TRCAP-5b), β-Cross Laps of type I collagen-containing cross-linked C-telopeptide (β-CTX), 25-hydroxyvitamin D, parathyroid hormone were recorded or detected. Bone mineral density (BMD) was our primary outcome. Based on the result of BMD, we divided both the control group and T2DM group into three subgroups: normal bone mass, osteopenia and osteoporosis. In control group, we found age, sex, menopausal status, BMI, P1NP, BALP, TRACP-5b, osteocalcin, and corrected serum calcium are differential among three subgroups. In T2DM group, we found age, sex, menopausal status, drinking status, BMI, HbA1c, TRACP-5b and OC were differential among three subgroups. In T2DM and control groups, age, female, postmenopausal status, BALP, TRACP-5b and osteocalcin were positively correlated while BMI was negatively correlated with osteoporosis. In control group, β-CTX was positively correlated with osteoporosis. In T2DM group, HbA1c and corrected serum calcium concentration were positively correlated with osteoporosis. After further adjustment of age, BMI in male, TRACP-5b was positively correlated with the risk of osteoporosis in newly diagnosed T2DM. After adjusted of age, BMI and menopausal status in female, OC was positively correlated with the risk of osteoporosis in newly diagnosed T2DM and controls. In female T2DM, BALP and P1NP were positively correlated with the risk of osteoporosis. In conclusion, age, BMI and menopausal status are common risk factors for osteoporosis in diabetic and non-diabetic patients, however TRACP-5b, BALP and osteocalcin are special risk factors for osteoporosis in newly diagnosed T2DM patients but not non-diabetic patients, which may be applied to identify osteoporosis risk in T2DM patients, but this result needs to be proven with fracture data.
Highlights
Type 2 diabetes has affected more than 451 million individuals worldwide, and its prevalence is steadily rising following the aging of the society [1]
If type 2 diabetes mellitus (T2DM) replaces RA in FRAX for evaluating fracture risk of the T2DM patients, this tool becomes more precise [6]. These above results imply that T2DM patients have unique bone metabolism characteristics and risk factors that contribute to their higher fracture risk
We found age (P-value
Summary
Type 2 diabetes has affected more than 451 million individuals worldwide, and its prevalence is steadily rising following the aging of the society [1]. FRAX underestimates the fracture risk of the type 2 diabetic patients even after it included femoral neck aBMD and several clinical variables (age, sex, body mass index, use of glucocorticoids, current smoking, alcohol intake of three or more units per day, secondary osteoporosis, rheumatoid arthritis, prior fragility fracture) [5]. Because of the widespread use of bone mineral density (BMD) and FRAX for predicting fracture risk in populations, lots of efforts have been put to explore the more precise way to use BMD and FRAX on fracture risk prediction in type 2 diabetic patients. If T2DM replaces RA in FRAX for evaluating fracture risk of the T2DM patients, this tool becomes more precise [6]. These above results imply that T2DM patients have unique bone metabolism characteristics and risk factors that contribute to their higher fracture risk
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