Whole body composition and regional bone mass in women with insulin‐dependent diabetes mellitus

Abstract

Reduced bone mass has been reported in adult patients with insulin-dependent diabetes mellitus but there are few data on bone density in the axial skeleton or on whole body composition in this group. The aim of this study was to determine whether whole body and regional bone mass are normal in middle-aged women with insulin-dependent diabetes mellitus. Total and regional bone mass were measured in 24 post-menopausal women aged 43-69 years (mean 56.3) with insulin-dependent diabetes, recruited during routine clinic attendance. Results were compared with those obtained from 24 age and weight-matched community-based post-menopausal women. Whole body bone mineral content and bone mass in the lumbar spine and femoral neck were measured by dual energy X-ray absorptiometry on a Lunar DPX. Whole body bone mineral content was significantly lower in the diabetic women than in community-based controls (P = 0.02). There was no significant difference between the two groups in whole body bone density or lumbar spine bone density. Mean bone density in the femur was lower in the patient group at all sites assessed (femoral trochanter P = 0.003, femoral neck, P = 0.057). Values for all regional bone density measurements in the diabetic women were within the Lunar reference range (mean +/- 2 SD) and at all sites the mean value was close to 100% of the sex and age-matched reference value. There was no correlation between duration or control of diabetes and bone mass at any site. Insulin-dependent diabetes mellitus in middle-aged women is associated with small reductions in total body bone mineral content and in femoral bone density; the clinical significance of these findings in terms of subsequent fracture risk remains to be established. No evidence was found in this study for a reduction in whole body or lumbar spine bone density.