The Prevalence and Risk Factors of Osteoporosis among a Saudi Female Diabetic Population

Abstract

AIM:This study aimed to assess the prevalence and determinants of osteoporosis [lumbar spine (LS) and femoral neck (FN)] among patients with type 2 diabetes at King Salman Hospital.MATERIALS AND METHODS:One hundred seventy patients with type 2 diabetes were enrolled in this cross-sectional study in the period from the 1st of January until the 1st of July 2015. Patient selection was based on self-report of the previous diagnosis by a physician, being on an antidiabetic agent, or a fasting glucose of 126 mg/dl as per the American Diabetes Association criteria. A dual energy X-ray absorptiometry scan with the bone mineral density (BMD) categorization based on the WHO cut of levels of T-scores and determination of vitamin D levels were performed. A detailed questionnaire was used to collect demographic data.RESULTS:Out of 170 participants, 50 (29.4%) were diagnosed as having osteoporosis, while 68 (40%) were diagnosed with osteopenia. Age was determined as a risk factor for a decreased BMD in patients with osteopenia (odds ratio (OR) = 1.1, 95% confidence interval (CI) = (1.0-1.1), p = 0.039) and osteoporosis (OR = 1.1, CI = 1.0-1.2, p < 0.001). Similarly, oral hypoglycemic agents (OHA) increased the risk of decreased BMD in osteopenia (OR = 2.6; CI = 1.0-6.7; p = 0.023) as well as osteoporosis, (OR = 3.8; CI = 1.3-10.9; p = 0.013), while vitamin D deficiency increased the risk of osteopenia OR = 3.0; CI = 1.2-7.2; p = 0.012). Increased BMI decreased the risk of both osteopenia and osteoporosis (OR = 0.9; CI = 0.9-0.99; p = 0.031 vs. OR = 0.9; CI = 0.80-0.95; p = 0.003).CONCLUSION:Advanced age, OHA and vitamin D deficiency are determinants of decreased BMD in Saudi women with type 2 diabetes, while an increased BMI protects against low BMD.

The Relationship Between Type 2 Diabetes Mellitus and Osteoporosis in Elderly Patients: A Retrospective Study

“…Similarly, Asokan et al [15] found no difference in BMI between the diabetic and non-diabetic participants. However these findings were against the observation of Saudi study [25], which showed that low BMI is associated with high risk of osteoporosis.…”

“…In contrast, several studies done in UAE [14], Saudi [25] and china [17] showed that T2DM patients were at higher risk for Copyright © Anood Jamal Alshaali AICS.000549. 2(5).2020 osteoporosis.…”

A comprehensive overview on osteoporosis and its risk factors

“…Advanced age, oral hypoglycemic agents and vitamin D deficiency are determinants of decreased BMD in Saudi women with type 2 diabetes. 162 Skeletal disorders in diabetes may be caused by multiple mechanisms including changes in insulin and IGF levels, hypercalciuria associated with glycosuria, reduced renal function, obesity, higher concentrations of advanced glycation end products (AGEs) in collagen, angiopathies, neuropathies and inflammation. 163 – 166 Comparison of BMD values in type 1 and type 2 diabetic patients of similar age showed that type 1 diabetes mellitus (T1DM) is associated with reduction in BMD.…”

Prevalence of osteoporosis in patients with diabetes mellitus: a systematic review and meta-analysis of observational studies

“…The aforementioned studies revealed the complex relation between BMI and BMD. Al-Homood et al [ 23 ] showed that BMI protects against a decrease in BMD, such a finding has been claimed by Chen et al in their study among elderly type 2 diabetic men [ 42 ]. Nonetheless, Doğan, A and his teammates [ 43 ] confirmed BMD values increased as BMI values increased and the effect of a high BMI on femoral neck and L2-L4 BMD among older men and women, but the effect of age was not shown above 75 years of age.…”