The effect of body mass index on osteoporosis and fracture risk in patients with type 2 diabetes mellitus

Yıl 2021, Cilt: 4 Sayı: 6, 882 - 885, 24.09.2021

Erol Öten , Mustafa Çapraz

https://doi.org/10.32322/jhsm.975852

Cited By: 1

Öz

Aim: Type 2 diabetes mellitus (DM), osteoporosis and obesity are increasingly common diseases due to the increase in the elderly population and the change in eating habits. However, the relationship between diabetes, obesity and osteoporosis has not been fully clarified in studies in the literature. In our study, it was investigated whether the combination of diabetes and obesity caused osteoporosis and increased fracture risk.
Material and Method: Our study was carried out with a total of 95 patients between the ages of 40 and 80, including 24 males and 71 females, who were tested due to the preliminary diagnosis of osteoporosis and diagnosed with type 2 DM in the physical medicine and rehabilitation outpatient clinic. The demographic characteristics, body mass index (BMI), bone mineral density (BMD) measurements, X-ray imaging, and fracture risk assessment scale (FRAX) calculations of patients were performed. Groups were compared in terms of BMD and FRAX according to the BMI classification.
Results: BMD and FRAX hip values were higher in the obese group according to the BMI classification compared to the pre-obese/normal group (p<0.05). In the obese group, the number of patients with a history of low-energy fractures and with identified fractures on X-ray scanning was higher compared to the pre-obese/normal group; however, there was no significant relationship between the groups (p>0.05).
Conclusion: As a result of our study, it was observed that type 2 DM and obesity were associated with increased fracture risk despite high BMD values.

Anahtar Kelimeler

Bone mineral density, osteoporosis, obesity, type 2 diabetes mellitus

Kaynakça

• Kurra S, Siris E. Diabetes and bone health: the relationship between diabetes and osteoporosis‐associated fractures. Diabetes/Metabolism Research and Reviews 2011; 27: 430-5.
• De Waard EA, van Geel TA, Savelberg HH, Koster A, Geusens PP, Van Den Bergh JP. Increased fracture risk in patients with type 2 diabetes mellitus: an overview of the underlying mechanisms and the usefulness of imaging modalities and fracture risk assessment tools. Maturitas 2014; 79: 265-74.
• Association AD. 2. Classification and diagnosis of diabetes. Diabetes Care 2017; 40: S11-S24.
• Schwartz A. Diabetes mellitus: does it affect bone? Calcified Tissue International 2003; 73: 515-9.
• Inzerillo AM, Epstein S. Osteoporosis and diabetes mellitus. Rev Endocr Metab Disord 2004; 5: 261-8.
• Vestergaard P. Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes—a meta-analysis. Osteoporos Int 2007; 18: 427-44.
• Walsh JS; Vilaca T. Obesity, type 2 diabetes and bone in adults. Calcif Tissue Int 2017; 100: 528-35.
• Felson DT, Zhang Y, Hannan MT, Anderson JJ. Effects of weight and body mass index on bone mineral density in men and women: the Framingham study. J Bone Miner Res 1993; 8: 567-73.
• Schwartz AV, Sellmeyer DE, Ensrud KE, et al. Older women with diabetes have an increased risk of fracture: a prospective study. J Clin Endocrinol Metabol 2001; 86: 32-8.
• Forsen L, Meyer H, Midthjell K, Edna TH. Diabetes mellitus and the incidence of hip fracture: results from the Nord-Trøndelag Health Survey. Diabetologia 1999; 42: 920-5.
• Janghorbani M, Van Dam RM, Willett WC, Hu FB. Systematic review of type 1 and type 2 diabetes mellitus and risk of fracture. Am J Epidemiol 2007; 166: 495-505.
• Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis Int 2013; 24: 23-57.
• Unni S, Yao Y, Milne N, Gunning K, Curtis J, LaFleur J. An evaluation of clinical risk factors for estimating fracture risk in postmenopausal osteoporosis using an electronic medical record database. Osteoporosis Int 2015; 26: 581-7.
• Organization WH. The Asia-Pacific perspective: redefining obesity and its treatment. 2000.
• Sealand R, Razavi C, Adler RA. Diabetes mellitus and osteoporosis. Curr Diabetes Rep 2013; 13: 411-8.
• Nielson CM, Marshall LM, Adams AL, et al. BMI and fracture risk in older men: the osteoporotic fractures in men study (MrOS). J Bone Miner Res 2011; 26: 496-502.
• Tanaka S, Kuroda T, Saito M, Shiraki M. Overweight/obesity and underweight are both risk factors for osteoporotic fractures at different sites in Japanese postmenopausal women. Osteoporosis Int 2013; 24: 69-76.
• Eryavuz Sarıdoğan M. Osteoporozun tanımı ve sınıflandırması. Modern Tıp Seminerleri 19: Osteoporoz 2001: 1-5.
• Fassio A, Idolazzi L, Rossini M, et al. The obesity paradox and osteoporosis. Eat Weight Disord 2018; 23: 293-302.
• de Paula FJ, Rosen CJ. Obesity, diabetes mellitus and last but not least, osteoporosis. Arq Bras Endocrinol Metabol 2010; 54: 150-7.
• Pritchard JM, Giangregorio LM, Atkinson SA, et al. Changes in trabecular bone microarchitecture in postmenopausal women with and without type 2 diabetes: a two year longitudinal study. BMC Musculoskelet Disord 2013; 14: 114.
• Viégas M, Costa C, Lopes A, Griz L, Medeiro MA, Bandeira F. Prevalence of osteoporosis and vertebral fractures in postmenopausal women with type 2 diabetes mellitus and their relationship with duration of the disease and chronic complications. J Diabetes Complications 2011; 25: 216-21.
• García-Hernández A, Arzate H, Gil-Chavarria I, Rojo R, Moreno-Fierros L. High glucose concentrations alter the biomineralization process in human osteoblastic cells. Bone 2012; 50: 276-88.
• Kanazawa I, Yamaguchi T, Yamamoto M, et al. Serum osteocalcin level is associated with glucose metabolism and atherosclerosis parameters in type 2 diabetes mellitus. J Clin Endocrinol Metabol 2009; 94: 45-9.
• Melton III LJ, Riggs BL, Leibson CL, et al. A bone structural basis for fracture risk in diabetes. J Clin Endocrinol Metabol 2008; 93: 4804-9.
• Burghardt AJ, Issever AS, Schwartz AV, et al. High-resolution peripheral quantitative computed tomographic imaging of cortical and trabecular bone microarchitecture in patients with type 2 diabetes mellitus. J Clin Endocrinol Metabol 2010; 95:5045-55.
• Lecka-Czernik B. Bone loss in diabetes: use of antidiabetic thiazolidinediones and secondary osteoporosis. Curr Osteoporos Rep 2010; 8: 178-84.