Objective: To investigate clinical characteristics and risk factors of osteoporosis in postmenopausal women with type 2 diabetes mellitus.
Method: A total of 410 postmenopausal women with type 2 diabetes of natural menopause with no history of fracture were collected from outpatients of Beijing Hospital (Oct 2017 - Nov 2019). Bone mineral density (BMD) at lumbar spine L1-L4 and hip was measured using dual-energy X-ray absorptiometry. Biochemical markers of bone and glucose metabolism were evaluated. Patients were divided into three groups based on BMD: A (osteoporosis): T ≤-2.5 SD; B (osteopenia) -2.5 < T ≤ -1 SD; C (normal bone mineral density) T > -1 SD. Statistical differences of age, menopausal age, diabetes age, BMI and biochemical indexes were compared between groups.
Result: 1. Case number based on lumbar spine BMD: 189 in A (46.1%), 147 in B (35.9%), and 74 in C (18.0%). ANOVA analysis showed group A patients had the highest age (F 5.698, p 0.004), age of diabetes onset (F 7.596, p 0.001), ALP (F 3.231, p 0.041) and menopausal duration (F 7.596, p 0.001), but the lowest BMI (F 11.456, p 0.000). Logistic multivariate regression showed body mass index is an independent risk factor for osteoporosis in postmenopausal women with type 2 diabetes [A vs. C: OR1.224 (95% CI 1.106-1.355, p 0.000); A vs. B: OR1.172 (95% CI 1.079-1.274, p 0.000].2. Case number based on femoral neck BMD: 159 in A (38.8%), 188 in B (45.9%), 63 in C (15.3%). ANOVA analysis showed group A patients had the highest age (F 21.484, p 0.000), age of diabetes onset (F 10.125, p 0.000) and PTH (F3.691, 0.026), but the lowest BMI (F 11.456, p 0.000). Logistic multivariate regression showed body mass index is an independent risk factor for osteoporosis in postmenopausal women with type 2 diabetes [A vs. C: OR1.267 (95% CI 1.120-1.433, p 0.000); A vs. B: OR1.195 (95% CI1.099-1.301, p 0.000)].
Conclusion: Osteoporosis in postmenopausal women with type 2 diabetes is associated with older age, longer menopause duration, older age of diabetes onset and lower BMI.
Y. Wang: None. Z. Lina: None. L. Guo: Consultant; Self; AstraZeneca, Bayer Healthcare Pharmaceuticals Inc., BD, Eli Lilly and Company, Merck & Co., Inc., Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk, Sanofi China.