Osteoporosis at Distal Radius in Otherwise Healthy Adult Patients with Type 2 Diabetes: Does it differ from Routine?Correspondence Address :
Dr. Balram Sharma,
Associate Professor, Department of Endocrinology, SMS Medical College and Hospitals, JLN Road, Jaipur, Rajasthan, India.
Introduction: Type 2 Diabetes Mellitus (T2DM) affects bone metabolism at axial as well as the appendicular skeleton. Bone loss may vary at different sites. Besides spine and hip, the distal radius is commonly evaluated for osteoporosis in T2DM. The study represents the findings of osteoporosis at distal radius in otherwise healthy T2DM cases.
Aim: To study osteoporosis at distal radius in relation to spine and hip in otherwise healthy T2DM cases.
Materials and Methods: In this cross-sectional, observational study, adult patients above 50 years of age with T2DM with no other comorbidities or bone disease were assessed. All patients underwent Bone Mineral Density (BMD) evaluation with Dual-Energy X-Ray Absorptiometry scan (DXA) at spine, hip and distal radius. T-score of <-2.5 was considered as osteoporosis. Student’s t-test and Chi-square test were used to detect statistically significant differences in continuous and categorical data. One-way analysis of variance (ANOVA) was used to compare continuous data in more than two groups. Pearson coefficient was determined to study the correlations. The p-value <0.05 was considered statistically significant.
Results: In 200 patients studied, osteoporosis at spine, hip and distal radius was found in 33.5%, 13.5% and 90.0% patients, respectively. Body mass index was significantly lower in patients with radial osteoporosis (p=0.048). There was a significant correlation between osteoporosis at the distal radius and osteoporosis at the spine (p<0.0001) and hip (p<0.0001). As osteoporosis was observed in a large number of patients; we further used T-score =-5.0 cut-off and observed osteoporosis in 37.5% patients. There was no difference in prevalence of osteoporosis in different age groups (p=0.510 and p=0.796) and two genders (p=0.203 and p=0.289) using either cut-off values. Vitamin D deficiency did not differ significantly in patients with or without osteoporosis using either cut-off values (p=0.603 and p=0.582).
Conclusion: Compared to spine and hip, the prevalence of osteoporosis was higher at distal radius (90.0%) using standard T-score cut-off (=-2.5). Therefore, distal radius site should be evaluated in all cases for osteoporosis in T2DM. Further research is necessary to study whether bone loss occurs early and faster at distal radius compared to other sites.
Bone loss, Diabetes, Distal forearm, Glucose, Hip, Spine
Balram Sharma, Vijay Kumar Bhavi, Sanjay Saran, Hardeva Ram Nehara, Anshul Kumar Singh, Sandeep Kumar Mathur. OSTEOPOROSIS AT DISTAL RADIUS IN OTHERWISE HEALTHY ADULT PATIENTS WITH TYPE 2 DIABETES: DOES IT DIFFER FROM ROUTINE?. Journal of Clinical and Diagnostic Research [serial online] 2018 December [cited: 2018 Dec 18 ]; 12:OC13-OC16. Available from
Date of Submission: Jul 30, 2018
Date of Peer Review: Aug 27, 2018
Date of Acceptance: Sep 25, 2018
Date of Publishing: Dec 01, 2018
FINANCIAL OR OTHER COMPETING INTERESTS: None.
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