Bone Mineral Density And Fracture Risk Assessment For Type2Diabetes Mellitus: A Case–control Study

Objective: The aim of the study was to observe the bone mineral density (BMD) intype2diabetes mellitus (T2DM), and discusses the relationship of BMD with fracturerisk and its influence factors.Methods: Select97type2diabetes patients who were hospitalized in the departmentof endocrinology, Fujian Medical University Affiliated Union Hospital, from June2012to February2013as the diabetes group (All subjects were consistent with diabetesdiagnostic criteria in1999), and choose96healthy people in the same period as thenormal group for compare. BMD of the right femur was measured by dual energy X-rayabsorptiometry (DXA).All clinical information was available for the FRAX algorithm ofChinese model to assess the10-year probability of a major osteoporotic fracture and a hipfracture.Results:(1) General clinical data comparison: Compared with control group, gender,age, menopausal age (MA), years since menopause (YSM), body mass index (BMI), afracture risk factor such as drinking and smoking of T2DM were no statisticallysignificant(P＞0.05);(2)Compare BMD and Fracture probability: BMD at total lumbarspine(L1-4), total hip(Th) and femoral neck(FN) with type2diabetic patients were nostatistically significant compared with control group (P>0.05); and the10-yearprobability of a major osteoporotic fracture and a hip fracture also have no statisticallysignificant compared with control group(P>0.05);(3)The relationship between FN-BMDand Fracture probability: In type2diabetes mellitus group, when BMD values wereincluded, the predicted10-year probability of major osteoporotic fractures and hipfractures were5.5%and2.1%, respectively, which was significantly higher than the sameevents when BMD values were not included (P<0.01), respectively, and the differences have statistically significance (P <0.01);(4)Relevance comparison: BMD has negativecorrelation with YSM（P＜0.01）, and has positive correlation with BMI (P<0.05). Thepredicted10-year probability of fracture has negative correlation with BMD at variousskeletal sites (P<0.05), but has positive correlation with age and YSM (P<0.01);(5)Multiple Linear Regression comparison: The influence factors of FN-BMD are gender,age, BMI and course of disease, but YSM is one of the influencing factors in women. Theinfluence factors of fracture probability are gender, FN-BMD, age, course of disease andBMI，and FN-BMD had more impact on the predicted10-year probability of both majorand hip osteoporotic fractures.Conclusion: In patients with T2DM in Fuzhou, China, BMD and the predicted10-year probability of a major osteoporotic fracture and a hip fracture were not differencefrom age-and gender-matched healthy population. And the effect of BMI and course ofdisease on fracture risk may mediate by acting on BMD. FN-BMD was the mostsignificant factor of the predicted risk of fracture in patients with T2DM. Application ofFRAX model to assess risk of fracture in patients with T2DM may have moresignificance than BMD alone.