بررسي سنجش تراكم استخوان در زنان يايسه ديابتي نوع دو در مقايسه با گروه شاهد

Bone mineral density in postmenopausal women with type II diabetes mellitus compared with control group

Diabetic osteopenia is a recognized but neglected complication of diabetes mellitus. Most studies have reported low BMD values in type 1, but the BMD results in type 2 is often conflicting. Considering the high prevalence of diabetes type 2 and the importance of osteopenia in postmenopausal women together with its socioeconomic and health burdens, we designed a controlled study of BMD in postmenopausal diabetic women. Proximal femoral and lumbar BMD findings in the subjects were compared to the healthy postmenopausal controls. BMD results from 65 postmenopausal women, aged 45-65 years old, with diabetes type 2 were compared with 85 age matched controls. BMD at proximal femur (neck, ward, trochanter) and lumbar spine (L2-lam) was performed using DEXA. Subjects were categorized as "diabetic - non osteopenic" (or high BMD) and "diabetic osteopenic - osteoporotic" (or low BMD) based on whether their femoral neck T-score were above or below -1, respectively. Serum levels of FBS, 2hpp glucose, HbA1C, Ca, Ph, alkaline phosphatase, urinary Ca and Na were also assessed between two subgroups. Mean BMD value of ward area in diabetic women was 0.644±0.165 glcm2 vs. 0.705±0.138 glcm2 in controls (P<0.03). Trochanteric mean BMD in cases was 0.658±0.21g/cm2 vs. 0.737±0.99 in controls (P=0.01). But at femoral neck and lumbar spine no significant difference was seen between two groups. The osteoporotic subgroup of diabetic patients showed higher levels of HbA1C, alkaline phosphase and 24h urinary Ca and Na, but lower levels of serum Ca and Ph, however, the differences did not reach statistical significance. Estrogen consumption was more common in high BMD patients (P=0.05). There was no significant difference between the case and control groups in respect of absent vertebral fractures in the course of recent five years. Age and span of time following menopause, appear to be major risk factors for osteopenia in diabetic patients. Despite higher body mass index in diabetes and considering the protective role of obesity on bone mass, there seems to be a significant decrease in ward and trochanteric BMD values in diabetic patients, indicating that factors other than obesity could affect their BMDs.