Authors
1
Tucom
2
College of Medicine/ Al-Nahrain University, Baghdad, Iraq
,
Document Type : Research Paper
Abstract
A
Background: Diabetes, whether type 1 or 2, is one of the world’s biggest health problems. The disease may affect all organ systems. The relationship between diabetes and bone mineral density (BMD) is a matter of debate.
Aims: To assess the effect of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) on the bone mineral density in adult patients.
Patients and Methods: This is a cross-sectional study which included a total of 25 patients with T1DM, 25 patients withT2DM and other 25 apparently healthy subjects. Bone mineral density was measured using densitometry. Serum calcium, phosphorus, alkaline phosphatase (ALP were measured spectrophotometrically.
Results: hip BMD and spine BMD were higher in T2DM (1.24±0.19 g/m2, and 1.22±0.22 g/m2, respectively) than T1DM (0.94±0.78 g/m2 and 11.02±0.3 g/m2, respectively) with significant difference. In T1DM group, spine Z-score had a positive significant correlation with BMI (r= 0.882, p<0.001). In T2DM group, Spine Z-score also had significant positive correlation with each of weight (r= 0.913, p<0.001) and BMI (r= 0.952, p<0.001).
Conclusions: Patients with T1DM have lower BMD in terms of spine and hip Z-score than patients with T2DM or healthy controls. Bone mineral density parameters positively correlate with body weight and BMI.
Key word:bone mineral density in diabetes patients
Keywords
-
Bone,,
-
,،,؛mineral,,
-
,،,؛density,,
-
,،,؛in,,
-
,،,؛diabetes
- Oei L, Rivadeneira F, Zillikens MC, Oei EHG. Diabetes, diabetic complications, and fracture risk. Curr Osteoporos Rep. 2015;13:106–15.
- Fan Y, Wei F, Lang Y, Liu Y. Diabetes mellitus and risk of hip fractures: a meta-analysis. Osteoporos Int. 2016;27:219–28.
- Shah VN, Shah CS, Pharm M, Snell-Bergeon JK. Type 1 diabetes and risk for fracture: meta-analysis and review of the literature. Diabet Med. 2015;32:1134–42.
- Janghorbani M, Feskanich D, Willett WC, Hu F. Prospective study of diabetes and risk of hip fracture. Diabetes Care. 2006;29:1573–78.
- Bonds DE, Larson JC, Schwartz AV, et al. Risk of fracture in women with type 2 diabetes: the Women’s health initiative observational study. J Clin Endocrinol Metabol 2006;91:3404–10.
- Botella-Martínez S, Varo Cenarruzabeitia N, Escalada San Martin J, et al. The diabetic paradox: Bone mineral density and fracture in type 2 diabetes. Endocrinol Nutr. 2016;63:495–501.
- Kim J, Kim E, Lee B, , et al: The effects of Lycii Radicis Cortex on RANKL-induced osteoclast differentiation and activation in RAW 264.7 cells. Int J Mol Med , 201;37: 649-58.
- Oei L, Zillikens MC, Dehghan A, et al. High bone mineral density and fracture risk in type 2 diabetes as skeletal complications of inadequate glucose control: The Rotterdam Study. Diabetes Care. 2013;36:1619-28.
- Meier C, Schwartz AV, Egger A, et al. Effects of diabetes drugs on the skeleton. Bone. 2016;82:93-100.
- Bilezikian JP, Josse RG, Eastell R, et al. Rosiglitazone decreases bone mineral density and increases bone turnover in postmenopausal women with type 2 diabetes mellitus. J Clin Endocrinol Metab. 2013;98:1519-28.
- Taylor SI, Blau JE, Rother KI. Possible adverse effects of SGLT2 inhibitors on bone. Lancet Diabetes Endocrinol. 2015;3:8-10.
- Carey JJ, Delaney MF. T-Scores and Z-Scores. Clinic Rev Bone Miner Metab 2010;8:113–21.
- Loxton P, Narayan K, Munns CF, Craig ME. Bone Mineral Density and Type 1 Diabetes in Children and Adolescents: A Meta-analysis. Diabetes Care. 2021;44:1898-905.
- Mastrandrea LD, Wactawski-Wende J, Donahue RP, et al. Young women with type 1 diabetes have lower bone mineral density that persists over time. Diabetes Care. 2008;31:1729-35.
- Asokan AG, Jaganathan J, Philip R, et al. Evaluation of bone mineral density among type 2 diabetes mellitus patients in South Karnataka. J Nat Sc Biol Med 2017;8:94-98.
- Tuominen JT, Impivaara O, Puukka P, et al. Bone mineral density in patients with type 1 and type 2 diabetes. Diabetes Care. 1999;22:1196-200.
- Wakasugi M, Wakao R, Tawata M, Gan N, et al. Bone mineral density by dual energy x-ray absorptiometry in patients with non-insulin-dependent diabetes mellitus. Bone 1193;14:29–33.
- Sosa M, Dominquez M, Navarro MC, Segarra MC, et al. Bone mineral metabolism is normal in non-insulin-dependent diabetes mellitus. J Diabetes Complications 1996 ;10:201-5.
- Vestergaard, “Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes—a metaanalysis,” Osteoporosis Int 2007; 18: 427–44.
- Strotmeyer and J. Cauler, “Diabetes mellitus, bone mineral density, and fracture risk,” Curr Opinion in Endocrinol Diabetes Obesity 2007;14:429–35.
- Bilha SC, Leustean L, Preda C, et al. Bone mineral density predictors in long-standing type 1 and type 2 diabetes mellitus. BMC Endocr Disord 2021; 21,156.
- Sauque-Reyna L, Salcedo-Parra MA, Sánchez-Vargas PR, et al. Densidad mineral ósea en pacientes con diabetes tipo 2. Rev Invest Clin. 2011;63:162-69.
- de Liefde I, van der Klift M, de Laet CE, et al. Bone mineral density and fracture risk in type-2 diabetes mellitus: the Rotterdam Study. Osteoporos Int 2005;16:1713-20.
- Moerman EJ, Teng K, Lipschitz DA, Lecka-Czernik B. Aging activates adipogenic and suppresses osteogenic programs in mesenchymal marrow stroma/stem cells: The role of PPAR-gamma2transcription factor and TGF-beta/BMP signaling pathways. Aging Cell. 2004;3: 379–89.
- Botolin S, McCabe LR. Inhibition of PPAR-Gamma prevents type I diabetic bone marrow adiposity but not bone loss. J Cell Physiol. 2006;209:967–76.
- Bazelier MT, de Vries F, Vestergaard P, Herings RM, Gallagher AM, Leufkens HG, et al. Risk of fracture with thiazolidinediones: An individual patient data meta-analysis. Front Endocrinol (Lausanne) 2013;4:11.
- Coe LM, Irwin R, Lippner D, McCabe LR. The bone marrow microenvironment contributes to type I diabetes induced osteoblast death. J Cell Physiol. 2011;226:477–83.
- Fraser JH, Helfrich MH, Wallace HM, Ralston SH. Hydrogen peroxide, but not superoxide, stimulates bone resorption in mouse calvariae. Bone. 1996;19:223–26.
- Suzuki K, Miyakoshi N, Tsuchida T, et al. Effects of combined treatment of insulin and human parathyroid hormone (1–34) on cancellous bone mass and structure in streptozotocin induced diabetic rats. Bone 2003;33:108-14.
)
