The prevalence and the risk factors for low-energy fractures in women with type 2 diabetes

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Olga Fazullina¹, Vadim Klimontov^2
1RICEL – Branch of IC&G SB RAS, fazullina@ngs.ru
²RICEL – Branch of IC&G SB RAS, klimontov@mail.ru

Background and aim: The modeling of the risk of osteoporosis-related fractures in women with type 2 diabetes is important issue for medicine. The aim of our study was to determine the prevalence and the risk factors for low-energy fractures in postmenopausal women with type 2 diabetes.

Materials and Methods: The study included 236 postmenopausal women with type 2 diabetes, from 50 to 75 years of age. Bone mineral density (BMD), T-score and total body composition were determined by dual-energy X-ray absorptiometry.

Results: A reduced BMD was revealed in 150 women, including 45 individuals with osteoporosis and 105 subjects with osteopenia. A history of fractures occurred in 72 patients (30.5%). Low-energy fractures were observed in the groups of osteopenia (n=8) and osteoporosis (n=14). The most common localization of low-energy fractures was the radius (57.9% of all low-energy fractures), and proximal femur (36.8%). Women with low-energy fractures were older (p<0.001), had a lower body mass index (p<0.001), longer duration of insulin therapy and duration of postmenopause (p=0.01 and p<0.001 respectively). When analyzing the total body composition women with low-energy fractures had less total fat mass, abdominal and hip fat mass, and less lean mass (all p<0.001). In discriminant analysis, the duration of type 2 diabetes was the most reliable factor associated with low-energy fractures (model parameters: p=0.01; F=6.2; recognition accuracy 87%).

Conclusions: The age, duration of diabetes, postmenopause and insulin treatment, as well as body composition parameters (fat mass and lean mass), should be taken into consideration when modeling the risk of low-grade fractures in postmenopausal women with type 2 diabetes.