Prevalence and predictors of osteopenia and osteoporosis in patients with type 2 diabetes mellitus: a cross-sectional study from a tertiary care institute in North India

Background Patients with type 2 diabetes mellitus (T2DM) have an increased risk of hip and vertebral fractures. The increased fracture risk has largely been attributed to poor bone quality and microarchitecture. The contribution of bone quantity, measured as areal bone mineral density (BMD), to the risk of fracture is variable with most studies showing an increase in BMD in T2DM. The present study was undertaken to find out the prevalence of osteoporosis and osteopenia (based on BMD) in a cohort of patients with T2DM and delineate the possible modifiable and non-modifiable risk factors. Methods In this cross-sectional observational study, 252 otherwise ostensibly healthy patients with T2DM underwent dual energy X-ray absorptiometry (DEXA) scan. Osteoporosis and osteopenia were defined based on T-scores. The effect of modifiable and non-modifiable risk factors on BMD and osteoporosis were assessed. Results The mean age of the cohort was 59.9 years with a M:F ratio 2.9:3.4. The mean BMD at the lumbar spine and hip were 0.892 g/cm(2) and 0.715 g/cm(2), respectively. Males had significantly higher BMD at both the sites compared to females. The prevalence of osteoporosis and osteopenia was 33% and 40%, respectively. Female gender, increasing age, normal body mass index (BMI), low serum 25-hydroxyvitamin D, and use of pioglitazone were significantly associated with the risk of osteoporosis. Conclusion The prevalence of osteoporosis and osteopenia in patients with T2DM is high. Female gender, increasing age, normal BMI, low serum 25-hydroxyvitamin D, and pioglitazone use further increase the risk of osteoporosis.