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Abstract: 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 65 age matched controls. BMD at proximal femur (neck, ward, trochanter) and lumbar spine (L2-L4) 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 g/cm2 vs. 0.705±0.138 g/cm2 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.

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Abstract

introduction: Osteoprosis is a well recognized health hazard for women who are the main group at risk.This study assessed the relative risk factors of osteoprosis in women referring to the Chamran Hospital densitometry center during the year 1386, with the aim of designing a formula to estimate the severity of osteoprosis based on its risk factors. Materials and Methods: This cross sectional analytic study used the data of outpatients (n=1047) who visited the Bone Densitometry Center of Chamran Hospital during the year 1386. Information was gathered using questionnaires, completed face to face and the cases underwent Dexa densitometry of the hip and vertebras. The data were analysed with SPSS software. Results: Of the patients, 73% were menopausal the average and standard deviation of age and weight was 54.5± (10.3), 69.5± (10.8) and the average and standard deviation of T-score of hip and lumbar spine was -1.88± (1.08), -1.04±(1.05). After assessment, the precipitating factors of osteoprosis of hip were age, menopause, time of menopause, history of fracture, history of taking calcium supplements and dosage, number of deliveries, and duration of breast feedings. The preventing factors were weight, OCPs, exercise, (p<0.05) being significant the percipitating factors in vertebras were age, menopause, time of menopause, diabetes, history of fracture, history of calcium supplement usage and dosage, number of deliveries, timing of breast feeding and the preventing factor was weight, (p=<0.05) being significant. Using the use of stepwise regression analysis, a minimal mathematical model for predicting of bone density of hip and lumbar spine was formulated. Then the mathematical model of hip in the form of clinical decision rule (CDR) was validated with less number of independent cases. Conclusion: Using the method mentioned, along with clinical findings and history, persons at risk of osteoporosis can be identified and early prevention and treatment are possible. This can also prevent unnecessary expenses of diagnostic procedures for people without the risks of osteoprosis.