Bone mineral density and its determinants in diabetes: the Fremantle Diabetes Study

Autor: Valentina Rakic, Timothy M. E. Davis, S. A. P. Chubb, F.M.A. Islam, Wendy A. Davis, Richard L. Prince
Rok vydání: 2006
Předmět:
Zdroj: Diabetologia. 49:863-871
ISSN: 1432-0428
0012-186X
DOI: 10.1007/s00125-006-0154-2
Popis: We assessed the effects of type 1 and type 2 diabetes on bone density and metabolism.We analysed bone mineral density (BMD) measured at the hip, spine and forearm using dual energy X-ray absorptiometry in 34 patients with type 1 and 194 patients with type 2 diabetes. Patients were from the community-based Fremantle Diabetes Study, and findings for them were compared with those from normal age- and sex-matched control subjects from the local community. Biochemical and hormonal markers of bone metabolism were measured in a subset of 70 patients.After adjusting for age and BMI, there was a lower BMD at total hip (p0.001) and femoral neck (p=0.012) in type 1 men vs control subjects, but type 1 women and matched controls had similar BMD at each site. There was a higher BMD at total hip (p=0.006), femoral neck (p=0.026) and forearm (p0.001) in type 2 women vs control subjects, but diabetes status was not associated with BMD in type 2 men after adjustment for age and BMI. Serum oestradiol, BMI, C-terminal telopeptide of collagen type 1 and male sex were consistently and independently associated with BMD at forearm, hip and femoral neck and explained 61, 55 and 50% of the total variance in BMD, respectively, at these sites. Spine BMD was independently associated with BMI and ln(oestradiol).Men with type 1 diabetes may be at increased risk of osteoporosis, while type 2 women appear to be protected even after adjusting for BMI. Low serum oestradiol concentrations may predispose to diabetes-associated osteoporosis regardless of sex.
Databáze: OpenAIRE
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