10-year fracture risk (FRAX®), mineral bone density and trabecular bone index in women with type 2 diabetes mellitus

The aim of the study was to assess the 10-year risk of fractures (FRAX®), taking into account the values of bone mineral density (BMD) and trabecular bone index (TBI) in a population sample of women over 55 years of age with type 2 diabetes mellitus (DM2).

Materials and methods. The study was carried out on the material of the population cohort of the international project HAPIEE (Novosibirsk). The design of the study is «case-control». Random groups of women aged 55-84 with and without DM2 were formed in combination with the presence or absence of fractures in the history (n = 103, group 4). Standardized questionnaires, anthropometry, densitometry (dual energy X-ray absorptiometry, DEXA), TBI and FRAX® fracture risk determination were performed on all people.

Results. Women with DM2 who reported a history fracture (group 1) had lower T-criteria in the femoral neck than women with DM2 without fracture (group 2), p = 0.039. However, the history of fracture in women with DM2 was accompanied by higher T-criteria values (by 0.3-0.5 SD) in the vertebrae and hips compared to women without DM (group 3). We did not get a significant difference in the TBI parameter between all 4 groups studied. We also found no difference in the risk of repeated fracture among women with and without DM2 using FRAX® without densitometry and TBI-adjusted FRAX® (p = 0.841, p = 0.094, respectively). In group 1 with DM2 and fractures, the risk for FRAX with T-test was lower than in group 3 without DM with fractures (p = 0.034 for the main fractures, p = 0.002 for the hip).

Conclusion. In the studied population groups «case-control» of women aged 55-84 years with diabetes mellitus and fractures in their history, the risk of FRAX® fractures is lower with regard to DEXA and does not differ significantly in terms of TBI in comparison with women without DM2 fractures. The data obtained reflect the difficulties in diagnostics and the need to search for additional methods of early diagnosis of increased risk of fractures in patients with DM2.

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