Bone Mineral Density and Fracture Risk Assessment in Type II Diabetic Patients
Journal Title: Journal of Medical Science And clinical Research - Year 2015, Vol 3, Issue 2
Abstract
Objectives: To assess BMD and its association with fracture risk in elderly type II diabetic patients by using Fracture Risk Assessment Tool as a standard predictor of fracture risk. Introduction: Diabetes mellitus is the most common health problem worldwide and is estimated to be 6 - 8% of the overall population world over. A change in bone health is one of the many complications of this metabolic disorder. Most of the studies reported reduced bone mineral density (BMD) in Type 1 diabetes with increased risk of osteoporotic fractures. However, there have been conflicting results on the effects of type II diabetes on BMD and incidence of osteoporotic fracture due to the pathogenic complexity of the condition. Fracture Risk Assessment (FRAX) tool is a standard predictor of fracture risk assessment and assesses the ten-year risk of osteoporosis fracture based on individual risk factors, with or without BMD. Methodology: A case control study was conducted on a purposive sample of 252 type II diabetic and non-diabetic patients from different health care centres of Karachi. The participants were asked to fill a detailed questionnaire about their personal, present and past medical history and risk factors of osteoporosis were assessed. Type II diabetics with a history of at least 3 years were included in the study. Patients with history of drug and hormone intake that affects bone metabolism or any disease or surgery involving any joint; cancer and renal failure were excluded from the study. BMD measurements were done by Bone Densitometer (SONOST 3000). BMD was calculated by combining BUA and SOS which yields the QUI index. Calcaneus bone of right heel was used for measurement. T scores were used to evaluate BMD and risk of osteoporosis and Osteopenia were assessed by FRAX tool. Results: The mean age of the diabetic patients was 60.16% (± 8.06) years whereas 59.8 (± 6.2) years in non-diabetic patients. Mean BMI among diabetic patients was 25.9 ± 5.7 kg/m2 while 24.4(± 4.43)Kg/m2 was in non-diabetic patients. Mean waist/hip ratio of the diabetic patients was 0.93 (+ 0.11) while of nondiabetic patients was 0.89 + 0.087. The mean SOS and BUA in diabetic population was 1509 (± 21.12) and 81.23 (± 16.725) while in non-diabetic was 1414 ± 30.5 and 71.88 ± 13.73 respectively. Of the respondents, 13.1% were males and 86.9% were females. 30.5% had a family history of osteoporosis and 69.5% didn’t have a family history of osteoporosis. The mean T score in diabetic patients was -1.46 ± 0.95 while in non-diabetic patients was -4.7 + -0.7. The major osteoporotic fracture risk and hip fracture risk was 9.3 ± 7.26% and 7.1 ± 5.2% in diabetics whereas 2.6 ± 0.5% and 1.3 ± 0.4% in non-diabetic patients respectively. A weak negative correlation (-0.32) has been observed between BMD and Hip Fracture risk among diabetic patients. Conclusion: Type 2 diabetic patients have increased risk for hip fractures despite of higher BMD
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Saima Ejaz
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