Bone Mineral Density and Vertebral Fractures in Postmenopausalwomen with Type 2 Diabetes

BRANCE ML ; RAMÍREZ STIEBEN LA; DOBRY R ; ANCA L; GONZÁLEZ A; LÓPEZ MI; BAYO S; SÁNCHEZ A; BRUN LR

Congreso; 20th PANLAR Meeting 2018; 2018

Long-standing diabetesmellitus (DM) has been associated with bone loss that can cause an increase infracture risk. Objectives: The aim of this study was to evaluate bone mineraldensity (BMD) and vertebral fractures (VFx) in patients with type 2 diabetes (DM2).In addition, 25OHD levels was evaluated. Methods: An observational study with 104 postmenopausal womenwith DM2 and 100 postmenopausal women as control group (CG) matched by age fromRosario city (32º52´18´´S) Argentina were carried out. Exclusion criteria:chronic renal or liver disease, cancer, autoimmune or connective diseases, orpatients treated with glucocorticoids, anticonvulsants or vitamin D. The BMD(g/cm2) was determined by DXA (Lunar Prodigy). VFx were assessed withdorsal and lumbar Rx by Genant classification. The total 25OHD (ng/ml) wasperformed by chemiluminescence. The results are expressed as mean±EE. Datadistribution was analyzed using the Kolmogorov-Smirnov test and the comparisonbetween groups were performed with parametric and non-parametric tests asappropriate. Results: The DM2 group consisted in 104postmenopausal women (63.1±0.7 years, 10.5±0.8 years of DM2 diagnosis and 7.5±0.1%of HbA1c). The CG consisted in 100 postmenopausal women with 64.7±0.8 years. TheDM2 group showed higher BMI (CG= 27.7±0.5, DM2= 33.5±0.6 kg/m2,p<0.0001) and higher percentage of obese and overweight patients (chi2 test,p<0.0001). BMD was significantly higher in DM2 (L1-L4: GC= 1.005±0.03[T-score: -1.53], DM2= 1.121±0.04 [T-score: -0.28]; p=0.0160; femoral neck: GC=0.798±0.014 [T-score: -1.31], DM2= 0.847±0.019 [T-score: -1.14]; p=0.0478).However the prevalence of VFx was significantly higher in DM2 (GC=12%, DM2=38%;chi2 test, RR: 3.16, p<0.0001). In both groups the 100% of VFx wereasymptomatic and most of them were rheumatologist´s findings because were notinformed in the spine Rx. 25OHD was significantly lower in DM2 (GC= 22.3±0.9,DM2= 19.0±0.8, p=0.0119) without differences between patients with and withoutVFx. In DM2, a higher percentage of 25OHD deficiency was found (GC= 40.0%, DM2=63.5%, p=0.0008). The 25OHD showed correlation with BMI (r= -0.18) and glucemia(r= -0.21). Conclusions: It is concluded that DM2patients have lower 25OHD levels and higher prevalence of VFx despite betterBMD. The spine Rx was useful to found VFx due to fragility in order to treatthe patient and avoid more relevant fractures that alter the quality of life.