The association between osteoporosis and diabetic neuropathy in patients with type 2 diabetes

Abstract

Objective The objective of this study was to evaluate the association between osteoporosis and diabetic peripheral neuropathy in patients with type 2 diabetes mellitus (T2DM). Background Diabetic complications and osteoporotic fractures are two of the most important causes of morbidity and mortality in older patients. There is increased fracture rate associated with T2DM, despite these patients having greater bone mineral density. Osteocalcin, one of the bone turnover markers, is a peptide secreted by bone cells and reflects bone formation and consequently indicates bone remodeling status; which is the major mechanism underlying osteoporosis. Patients and methods This case–control study was done on 78 patients with T2DM. They were classified into two groups. Group I (neuropathy group) included 39 patients with diabetic neuropathy. Group II (control group) included 39 patients without diabetic neuropathy. Dual-energy X-ray absorptiometry (DEXA) and serum osteocalcin measurement were done for both the studied groups. Results There was no significant difference between the two studied groups in the DEXA scan results; the mean least T-score of the neuropathy group was −1.4 and that of the control group was −1.2 (P = 0.27). The mean osteocalcin level of the neuropathy group was 35.8, whereas that of the control group was 13.8, showing significant difference between the two groups (P = 0.03). Conclusion Osteoporosis is more prevalent in T2DM with microvascular complications, and serum osteocalcin level is better in its diagnosis than DEXA scan.