Diabetes and premature menopause: is their co-existence detrimental to the skeleton?

Objective: Premature menopause is a known risk factor for osteoporosis, whilst the influence of type 2 diabetes on bone mineral density (BMD) is still controversial. Design and methods: BMD values assessed by dual-energy X-ray absorptiometry (DXA) in L2–L4 vertebrae and the femoral neck (FN) of 40 diabetic women with premature menopause (D-EMP) were compared with those of 60 non-diabetic, prematurely menopausal women (EMP) and 60 diabetic women with normal menopause (D-NMP) who had been matched by age and body mass index (BMI). In all women, the time elapsed since menopause ranged between 10 and 25 years and the duration of diabetes exceeded 75% of the postmenopausal time period. The age of D-EMP women was 58.7±5 years (mean±1 s.d.), age at menopause 39.5±2.7, years since menopause 18.6±4.9, BMI 27.8±4.3 kg/m2 and duration of diabetes 13.9±3.9 years. Results: Vertebral BMD values of D-EMP women were significantly higher than those of EMP women (0.908±0.135 vs. 0.817±0.14 g/cm2, P = 0.002), although there was no significant difference between D-EMP and D-NMP women (0.886±0.15 g/cm2). No significant differences were observed in FN BMD values between all groups. Age-adjusted BMD values (Z scores) of D-EMP women were higher than EMP women in both anatomic sites (P < 0.01), but did not differ from D-NMP women. In contrast to the other two groups, no statistically significant correlation was observed in D-EMP women between the BMD values of either anatomic area and the time elapsed since menopause. HbA1c values were positively correlated only to vertebral BMD values of the D-EMP group (P < 0.05). No correlation was observed between the BMD values and the duration of diabetes either in D-EMP or in D-NMP women. Conclusions: Type 2 diabetes seems to positively affect the mineral density of the trabecular bone in women with premature menopause. The duration of diabetes does not appear to influence bone mass.

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Clinical significance of intramammary arterial calcifications in diabetic women

Vojnosanitetski pregled ◽

10.2298/vsp0402163m ◽

2004 ◽

Vol 61 (2) ◽

pp. 163-167 ◽

Cited By ~ 2

Author(s):

Zorica Milosevic ◽

Jelica Bjekic ◽

Stanko Radulovic ◽

Branislav Goldner

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Control Group ◽

Duration Of Diabetes ◽

Diabetic Macroangiopathy ◽

Indirect Sign ◽

Significant Difference

Background. It is well known that intramammary arterial calcifications diagnosed by mammography as a part of generalized diabetic macroangiopathy may be an indirect sign of diabetes mellitus. Hence, the aim of this study was to determine the incidence of intramammary arterial calcifications, the patient?s age when the calcifications occur, as well as to observe the influence of diabetic polineuropathy, type, and the duration of diabetes on the onset of calcifications, in comparison with nondiabetic women. Methods. Mammographic findings of 113 diabetic female patients (21 with type 1 diabetes and 92 with type 2), as well as of 208 nondiabetic women (the control group) were analyzed in the prospective study. The data about the type of diabetes, its duration, and polineuropathy were obtained using the questionnaire. Statistical differences were determined by Mann-Whitney test. Results. Intramammary arterial calcifications were identified in 33.3% of the women with type 1 diabetes, in 40.2% with type 2, and in 8.2% of the women from the control group, respectively. The differences comparing the women with type 1, as well as type 2 diabetes and the controls were statistically significant (p=0.0001). Women with intramammary arterial calcifications and type 1 diabetes were younger comparing to the control group (median age 52 years, comparing to 67 years of age, p=0.001), while there was no statistically significant difference in age between the women with calcifications and type 2 diabetes (61 years of age) in relation to the control group (p=0.176). The incidence of polineuropathy in diabetic women was higher in the group with intramammary arterial calcifications (52.3%) in comparison to the group without calcifications (26.1%), (p=0.005). The association between intramammary arterial calcifications and the duration of diabetes was not found. Conclusion. The obtained results supported the theory that intramammary arterial calcifications, detected by mammography could serve as markers of co-existing diabetes mellitus and therefore should be specified in radiologic report in case of their early development.

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Prevalence of osteoporosis and osteoporotic fractures in postmenopausal women with type 2 diabetes mellitus

Beyond Rheumatology ◽

10.4081/br.2021.71 ◽

2021 ◽

Vol 3 (3) ◽

Author(s):

Lamia Oulkadi ◽

Bouchra Amine ◽

Imane El binoune ◽

Samira Rostom ◽

Rachid Bahiri

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Postmenopausal Women ◽

Mineral Density ◽

Control Subjects ◽

Increased Risk ◽

Significant Difference ◽

Prevalence Of Osteoporosis

Type 2 diabetes mellitus (T2DM) and osteoporosis are chronic diseases with increasing prevalence. The aim of this study was to determine the prevalence of osteoporosis and osteoporotic fracture in women with T2DM and to identify predictive factors of fracture occurrence. The prevalence of osteoporosis and fractures in postmenopausal women with T2DM was 23.1% and 16.9%, respectively. 46.2% of T2DM patients had normal bone mineral density (BMD) (P<0.01) and 58.5% of control subjects had osteopenia (P<0.01). Incidence of fracture in T2DM patients with osteopenia was significantly increased versus control subjects when stratified according the BMD (P=0.009). By stratifying T2DM patients according to fractures, factors that were significantly associated with occurrence included T2DM duration (P=0.038), use of insulin (P=0.017), and lower BMD (P=0.048). Our study suggests that there was a higher prevalence of fracture in T2DM patients compared to control subjects and a significant difference in BMD was found between the groups. We also showed that insulin use, low BMD, and long duration of T2DM are factors associated with an increased risk of bone fracture.

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Effect of Dipeptidyl Peptidase-4 Inhibitors on Bone Health in Patients with Type 2 Diabetes Mellitus

Journal of Clinical Medicine ◽

10.3390/jcm10204775 ◽

2021 ◽

Vol 10 (20) ◽

pp. 4775

Author(s):

Dong-Hwa Lee ◽

Kyong Young Kim ◽

Min Young Yoo ◽

Hansol Moon ◽

Eu Jeong Ku ◽

...

Keyword(s):

Type 2 Diabetes ◽

Bone Health ◽

Trabecular Bone Score ◽

Control Group ◽

Mineral Density ◽

Retrospective Case ◽

Significant Difference ◽

Dipeptidyl Peptidase 4 Inhibitors ◽

Delta Change

Patients with type 2 diabetes (T2DM) have a higher risk of bone fracture even when bone mineral density (BMD) values are normal. The trabecular bone score (TBS) was recently developed and used for evaluating bone strength in various diseases. We investigated the effect of DPP-4 inhibitors on bone health using TBS in patients with T2DM. This was a single-center, retrospective case-control study of 200 patients with T2DM. Patients were divided into two groups according to whether they were administered a DPP-4 inhibitor (DPP-4 inhibitor group vs. control group). Parameters related to bone health, including BMD, TBS, and serum markers of calcium homeostasis, were assessed at baseline and after one year of treatment. We found TBS values increased in the DPP-4 group and decreased in the control, indicating a significant difference in delta change between them. The BMD increased in both groups, with no significant differences in delta change between the two groups observed. Serum calcium and 25-hydroxy vitamin D3 increased only in the DPP-4 inhibitor group, while other glycemic parameters did not show significant differences between the two groups. Treatment with DPP-4 inhibitors was associated with favorable effects on bone health evaluated by TBS in patients with T2DM.

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The Relationship Between Bone Mineral Density and Type 2 Diabetes in Obese Children and Adolescents at the Time of Initial Diagnosis

Hormone and Metabolic Research ◽

10.1055/a-0755-2799 ◽

2018 ◽

Vol 51 (01) ◽

pp. 42-46

Author(s):

Hae Lee ◽

Jong Yoon ◽

Kyu Park ◽

Jung Lim ◽

Jin Hwang

Keyword(s):

Bone Mineral Density ◽

Type 2 Diabetes ◽

Lumbar Spine ◽

Children And Adolescents ◽

Bone Mineral ◽

Tanner Stage ◽

Mineral Density ◽

Femur Neck ◽

Z Scores

AbstractLong-term effects of type 2 diabetes mellitus (T2D) on bone health remain unclear. The objective of this study was to assess the possible association of bone mineral density (BMD) at multiple sites with T2D after correcting for several potential confounders such as age, sex, Tanner stage, and BMI known to affect BMD in adolescents with newly developed T2D. In this cross-sectional study, 17 children and adolescents with T2D and 59 age, sex, and BMI-matched controls were included. All subjects underwent dual-energy X-ray absorptiometry to measure regional and whole-body composition with Lunar Prodigy at the time of initial diagnosis. A BMD Z-score was calculated using data from healthy Korean children and adolescents after adjusting for height-for-age. The mean age of all subjects was 12.9±2.4 years (range, 8.3–18.3 years). BMDht Z-scores for lumbar spine and total body after adjusted for age, sex, BMI SDS, and Tanner stage were not significantly different between patients and controls. However, BMDht Z-scores for femur neck and bone mineral apparent density (BMAD) Z-scores of lumbar spine were significantly lower in T2D patients than those in healthy controls. HOMA-IR or HbA1c was not associated with BMDht Z-scores at multiple sites. BMDht Z-scores at multiple sites except femur neck in adolescents with newly developed T2D were similar to those in obese controls after adjustment for potential confounders.

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Relationships between serum adiponectin levels versus bone mineral density, bone metabolic markers, and vertebral fractures in type 2 diabetes mellitus

Acta Endocrinologica ◽

10.1530/eje-08-0642 ◽

2009 ◽

Vol 160 (2) ◽

pp. 265-273 ◽

Cited By ~ 68

Author(s):

Ippei Kanazawa ◽

Toru Yamaguchi ◽

Masahiro Yamamoto ◽

Mika Yamauchi ◽

Shozo Yano ◽

...

Keyword(s):

Bone Mineral Density ◽

Type 2 Diabetes ◽

Vertebral Fractures ◽

Serum Adiponectin ◽

Mineral Density ◽

Hmw Adiponectin ◽

Total Adiponectin ◽

Menopausal Women ◽

Post Menopausal

BackgroundAlthough, adiponectin might be associated with bone metabolism, the relationships between serum adiponectin and bone mineral density (BMD) as well as vertebral fracture in type 2 diabetes are still unclear.Objective and methodsWe investigated the relationships between each of serum total and high molecular weight (HMW) adiponectin versus BMD, bone markers, and the presence of vertebral fractures in a total of 231 men and 170 post-menopausal women with type 2 diabetes.ResultsMultiple regression analysis adjusted for age, duration of diabetes, BMI, serum creatinine, and HbA1c showed that serum total adiponectin was negatively correlated with BMD at the total, lumbar spine, and femoral neck (r=−0.165, P<0.05; r=−0.187, P<0.05; and r=−0.136, P<0.05 respectively) and positively with urinary N-terminal cross-linked telopeptide of type-I collagen in men (r=0.148, P<0.05), and that serum HMW adiponectin was negatively correlated with BMD at the lumbar spine (r=−0.146, P<0.05). Multivariate logistic regression analysis adjusted for the parameters described above showed that total adiponectin was associated with the presence of vertebral fractures in men (odds ratio (OR)=1.396, 95% confidential interval (CI) 1.020–1.911 per s.d. increase, P<0.05), and both total and HMW adiponectin were associated with moderate or severe vertebral fractures (OR=1.709, 95% CI 1.048–2.787 per s.d. increase, P<0.05 and OR=1.810, 95% CI 1.112–2.946 per s.d. increase, P<0.05 respectively), but not in post-menopausal women.ConclusionsSerum adiponectin could be associated with BMD and turnover and clinically useful for assessing the risk of vertebral fractures in type 2 diabetic men.

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The effects of type 2 diabetes mellitus on the corneal endothelium and central corneal thickness

10.21203/rs.3.rs-109433/v1 ◽

2020 ◽

Author(s):

Tae Gi Kim ◽

Yoo Jin Kim

Keyword(s):

Type 2 Diabetes ◽

Endothelial Cell ◽

Central Corneal Thickness ◽

Corneal Thickness ◽

Corneal Endothelial Cell ◽

Control Group ◽

Diabetic Patients ◽

Duration Of Diabetes ◽

Significant Difference

Abstract Aim of this study is to evaluate the differences in corneal endothelial cell morphology and corneal thickness in patients with and without type 2 diabetes related to age, disease duration, and HbA1c percentage. This retrospective cross-sectional study included 511 type 2 diabetes patients (1022 eyes) and 900 (1799 eyes) non-diabetic patients. The endothelial cell density (ECD), variation in endothelial cell size (CV), percentage of hexagonal cells, and central corneal thickness (CCT) were analyzed using a noncontact specular microscope and a Pentacam Scheimpflug camera. We also examined the correlation between the corneal parameters and the duration of diabetes. Blood HbA1c results in DM patients were used within 2 months of ophthalmic examination. The controls had no diabetes confirmed by blood tests. For all ages, the subjects with type 2 diabetes showed significantly lower ECD, hexagonality, higher CV, and thicker CCT than the control group. This difference was more pronounced in patients with long-standing DM (≥10 years) and high HbA1c (≥7 %). When stratified by age group, from the 60s group, corneal endothelial cell parameters showed a statistically significant difference between DM and control groups. The duration of diabetes was inversely correlated with ECD (r=-0.167; P=0.000), but HbA1c was not correlated with ECD. These findings suggest that diabetes affects corneal endothelial cell in older age and those with long-standing DM and higher HbA1c. Regular corneal endothelial examinations are required in diabetic patients.

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Bone Mass and Density in Youth with Type 2 Diabetes, Obesity, and Healthy Weight

10.2337/figshare.12665486 ◽

2020 ◽

Author(s):

Joseph M. Kindler ◽

Andrea Kelly ◽

Philip R. Khoury ◽

Lorraine E. Levitt Katz ◽

Elaine M. Urbina ◽

...

Keyword(s):

Type 2 Diabetes ◽

Bone Mass ◽

Fracture Risk ◽

Visceral Fat ◽

Whole Body ◽

Areal Bone Mineral Density ◽

Healthy Weight ◽

Mineral Density ◽

Z Scores

Objective: Youth-onset type 2 diabetes is an aggressive condition with increasing incidence. Adults with type 2 diabetes have increased fracture risk despite normal areal bone mineral density (aBMD), but the influence of diabetes on the growing skeleton is unknown. We compared bone health in youth with type 2 diabetes to controls with obesity or healthy weight. Research Design and Methods: Cross-sectional study of youth (56% African American, 67% female) ages 10-23 years with type 2 diabetes (n=180), obesity (BMI>95th; n=226), or healthy weight (BMI<85th; n=238). Whole body (less head) aBMD and lean mass, and abdominal visceral fat were assessed via DXA. Lean body mass index (LBMI) and aBMD standard deviation (SD) scores (“Z-scores”) were computed using published reference data. Results: We observed age-dependent differences in aBMD and LBMI Z-scores between the healthy weight, obese, and type 2 diabetes groups. In children, aBMD and LBMI Z-scores were greater in the type 2 diabetes vs obese groups, but in adolescents and young adults, aBMD and LBMI Z-scores were lower in the type 2 diabetes vs. obese group (age interactions P<0.05). In the type 2 diabetes and obese groups, aBMD was about 0.5 SDs lower for a given LBMI Z-score compared to healthy weight controls (P<0.05). Further, aBMD was lower in those with greater visceral fat (β=-0.121, P=0.047). Conclusions: These results suggest that type 2 diabetes may be detrimental to bone density around the age of peak bone mass. Given the increased fracture risk in adults with type 2 diabetes, there is a pressing need for longitudinal studies aimed at understanding the influence of diabetes on the growing skeleton.

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Diagnostic Value of Carotid Artery Intima-media Thickness in Patients with Type 2 Diabetes and its Correlation with HbA1c Levels

Jundishapur Journal of Chronic Disease Care ◽

10.5812/jjcdc.111308 ◽

2021 ◽

Vol 10 (2) ◽

Author(s):

Hamid Dehdashti Sharokh ◽

Mehrnoosh Zakerkish ◽

Amir Hossein Sina ◽

Azadeh Saki ◽

Farzaneh Forouzan ◽

...

Keyword(s):

Type 2 Diabetes ◽

Carotid Artery ◽

Intima Media Thickness ◽

Ultrasound Measurement ◽

Neck Extension ◽

Related Field ◽

Duration Of Diabetes ◽

Media Thickness ◽

Significant Difference

Objectives: This study aimed to assess the role of carotid ultrasonography and measure the carotid artery intima-media thickness (CIMT) and its correlation with hemoglobin A1c (HbA1c) to observe cardiovascular disease (CVD) risks in patients with type 2 diabetes mellitus (T2DM). Methods: In this observational study, 205 consecutive patients with T2DM from Golestan Hospital, Ahvaz, Iran, were included. We performed HbA1c measurements using high-pressure liquid chromatography (HPLC) with a thermo-system. Carotid arteries ultrasonography was performed with an Aloka SSD 5500 apparatus with a 7.5 MHz transducer. The CIMT was measured in the supine position with a slight neck extension. Results: There was no statistically significant difference between the two study groups in the duration of diabetes with CIMT (P = 0.425), while the differences in creatinine, HbA1c, and urine albumin were statistically significant (P = 0.020, P = 0.041, and P = 0.016, respectively). There was no correlation between CIMT and age (r = 0.19, P = 0.792) and duration of diabetes (r = 0.125, P = 0.081). Furthermore, there was no remarkable association between CIMT and weight (r = 0.12, P = 0.881) and FBS ( r = 0.062, P = 0.405). There was also a non-significant negative correlation between HbA1c% and CIMT (r = -0.127, P = 0.127). Conclusions: Ultrasound measurement of CIMT is a safe and relatively cost-effective way of diagnosing atherosclerosis. Thus, the ultrasound's predictive value as a safe and non-invasive examination may alert the related field experts early enough to intervene to prevent major cardiovascular complications.

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