The State of Bone Mineral Density in Postmenopausal Women with Type 2 Diabetes Mellitus
Background. The problem of impairment of bone mineral density (BMD) in postmenopausal women is relevant due to a high risk of osteoporotic fractures, especially against the comorbid pathology. The aim of the study was to assess the impact of diabetes mellitus (DM) type 2 on the bone mineral density in postmenopausal women of different age depending on DM duration and type of antiglycemic treatment. Materials and methods. BMD was studied in 38 postmenopausal patients with DM type 2 (average age 64.36 ± 1.95 years old, average duration of DM type 2 10.68 ± 1.88 years, average glycated hemoglobin 9.02 ± 0.29 %). BMD state was measured by dual energy X-ray absorptiometry. BMD was estimated using T-criteria. Results. Postmenopausal women without DM were found to have decreases BMD with aging by T-criteria. T-criteria of lumbar spine L1–L4 I women aged 50–59 years old was –0.24 ± –0.22 that confirms osteopenia. In women aged 60–69 years old T-criteria was –2.20 ± –0.22 that confirms osteoporosis. The age changes of average values of T-criteria in DM type 2 were found to be less negative compared with a control group, but worse densitometric parameters on L1–L4 level at the age ≤ 60 years old (–0.71 ± –0.09 vs –0.24 ± –0.02 (P < 0.001). Conclusion. BMD in postmenopausal women with DB type 2 and without DM assessed by T-criteria decreased in all regions with aging. Postmenopausal women with DB type 2 had worse densitometric parameters by T-criteria on L1–L4 level at the age ≤ 60 years old. With increasing DB duration over 10 years densitomentric density of femoral neck reduces, and lumbar spine BMD by T-criteria are inverse. Insulin therapy does not improve femoral BMD by T-criteria, however positive effect of insulin therapy improves state of lumbar spine.
Full Text:PDF (Українська)
Atanova YaO, Kyryliuk ML. Effects of type 2 diabetes mellitus on bone metabolism in postmenopausal women. Healh of Woman. 2016;3(109):115-119 (Ukrainian).
Vayda VM. Bone mineral density of the spine in women of different ages. Litopys travmotolohiyi ta ortopediyi. 2011;1-2:244-245. (Ukrainian).
Kyryliuk ML, Atanova YaO. State of the bone hormonal functions in postmenopausal women with type 2 diabetes. Clinical Endocrinology and Endocrine Surgery. 2016;2(54):62-67. (Ukrainian)
Kyryliuk ML, Atanova YaO, Tretiak OE. Phosphorus and calcium metabolism in postmenopausal women with diabetes mellitus: effects of the type and duration of the disease, time of menopause and body mass. International Journal of Endocrinology. 2016;1(73):87-91 (Ukrainian).
Mkrtumyan AM. Modern possibilities of solving the problem of osteoporosis in patients with type 2 diabetes. Effektivnaya farmakoterapiya. 2014;53:70-76 (Russian).
Musienko AS. Bone mineral density and FRAX parameters in postmenopausal women. Bol'. Sustavy. Pozvonochnik. 2012;1(05) (Ukrainian).
Ma L. et al. Association between bone mineral density and type 2 diabetes mellitus: a meta-analysis of observational studies. Eur. J. Epidemiol. 2012;27:319–332.
Gorman E. et al. Bone health and type 2 diabetes mellitus: a systematic review. Physiother. Can. 2011;63(1):8-20.
Rakic V, Davis WA, Chubb SA, Islam FM. et al. Bone mineral density and its determinants in diabetes: the Fremantle Diabetes Study. Diabetologia. 2006;49(5):863–871.
Hampson G. et al. Bone mineral density, collagen type 1 alpha 1 genotypes and bone turnover in premenopausal women with diabetes mellitus. Diabetologia. 1998;41:1314-1320.
Adil C. et al. Bone mineral density evaluation of patients with type 2 diabetes mellitus. J. Phys. Ther. Sci. 2015;27(1):179-82.
Weinstock RS. et al. Bone mineral density in women with type II diabetes mellitus. J. Bone Miner. Res. 1989;4:97-101.
Sosa M. et al. Bone mineral metabolism is normal in non-insulin-dependent diabetes mellitus. J. Diabetes Complications. 1996;10:201-205.
Brown JP, Josse RG. Сlinical practice guidelines for the diagnosis and management of osteoporosis in Canada. Can. Med. Assoc. J. 2002;167(Suppl.10):1-34.
Majima T, Komatsu Y, Yamada T, Koike Y. et al. Decreased bone mineral density at the distal radius, but not at the lumbar spine or the femoral neck, in Japanese type 2 diabetic patients. Osteoporos. Int. 2005;16:907-913.
Gerdhem P. et al. Increased bone density and decreased bone turnover, but no evident alteration of fracture susceptibility in elderly women with diabetes mellitus. Osteoporos. Int. 2005;16:1506-1512.
Johnston CCJr, Hui SL, Longcope C. Bone mass and sex steroid concentrations in postmenopausal Caucasian diabetics. 1985;34:544-550.
Zhou Y. et al. Prevalence and predic-tors of osteopenia and osteoporosis in postmenopausal Chinese women with type 2 diabetes. J. Diabetes Res. Clin. Pract. 2010;90:261-269.
Sayers A, Lawlor DA, Sattar N, Tobias JH. The association between insulin levels and cortical bone: findings from a cross-sectional analysis of pQCT parameters in adolescents. Journal of Bone and Mineral Research. 2012;27(3):610-618.
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;18:427-444.
Copyright (c) 2020 M.L. Kyryliuk, Ya.O. Atanova, V.B. Dohotar
This work is licensed under a Creative Commons Attribution 4.0 International License.
© "Publishing House "Zaslavsky", 1997-2020