Relationship between Type 2 Diabetes Mellitus and Lumbar Bone Mineral Density in Postmenopausal Women

Study Design: Cross-sectional study using radiological measurements. Purpose: To analyze the relationship between type 2 diabetes mellitus (DM) and bone mineral density (BMD) in postmenopausal women and to assess risk factors of osteoporotic vertebral compression fracture (OVCF) in postmenopausal diabetic women. Overview of Literature: Type 2 DM has negative effects on the quality of bone. Patients with type 2 DM have increased risk of hip and other fractures, but their vertebral fracture risk is controversial. There is a positive correlation between body mass index (BMI) and BMD. At the same time, obesity is the most important risk factor for type 2 DM. Methods: Consecutive patients whose BMD had been checked using dual-energy X-ray absorptiometry at Gwangmyung Sungae Hospital were recruited. Patients were divided into two groups according to the presence of type 2 DM. Risk factors of OVCF including age, BMI, current smoking status, current alcohol consumption, and presence of osteoporosis were analyzed separately in the type 2 DM group and control group. Results: A total of 1,130 patients were enrolled in this study. The mean age was 63.2 years. BMI was positively correlated with lumbar BMD in the control group (r=0.284) and in the diabetic group (r=0.302). In subgroup analysis, BMI and age were significant risk factors of OVCF in the type 2 DM group. In multiple linear regression analysis, type 2 DM (beta=0.035; 95% confidence interval [CI], 0.005-0.065; p=0.024) and BMI (beta=0.015; 95% CI, 0.012-0.018; p<0.001) were positively correlated with lumbar BMD, and age was negatively correlated with BMD (beta=-0.006; 95% CI, -0.007 to -0.004; p<0.001). Conclusions: BMI was positively correlated with lumbar BMD and was higher in type 2 diabetic patients. Age was negatively correlated with lumbar BMD.