Potential cause affecting bone quality in Saudi Arabia: New insights

Background: Osteoporosis (OP) is a silent systemic disease characterized by decrements in bone mineral density (BMD) and bone microstructure. This study aimed to determine the status of bone quality as well as to investigate the relationship between the glycaemic; lipid; bone profiles; and the BMD. Methods: A retrospective study was conducted at KFHU, Al Khobar, Saudi Arabia analysis of patients who underwent BMD testing between the periods of 2016 to 2018. Based on the T scores, patients were classified as follows: normal (>-1.0), osteopenic (-1.0 to -2.5), or osteoporotic (<=-2.5). Details about medical and demographic information as well as metabolic and bone profiles (fasting blood glucose [FBG], glycated haemoglobin [HbA1c], cholesterol [Chol], high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides [TG], calcium [Ca], phosphorus [Ph], alkaline phosphatase [ALP], vitamin D 25OHD [Vit D]) were extracted from the medical records system. Results: Out of 4838 extracted profiles, there were 4196 females (85.1%). The mean glycaemic variables of patients showed an abnormal profile (FBG 118 +/- 49 and HbA1c 6.6 +/- 2). The mean T score showed that the majority of patients had either osteopenic (40%) or osteoporotic (24%) changed. Significant increase in mean HbA1c (7.6 +/- 1.7) was obvious among the osteopenic patients when judged against the normal (7.5 +/- 1.6; P < 0.033) and osteoporotic (7.4 +/- 1.8; P < 0.037). Meanwhile, the mean serum ALP was significantly lower (81 +/- 26) in the normal group than in the osteopenic (86 +/- 33; P < 0.006) and osteoporotic groups (90 +/- 40; P < 0.001). Finally, a linear, logistic regression analysis was found that Ca and ALP levels were significant predictors. Conclusion: This study finds that the main cause that affects bone quality in Saudi Arabia is diabetes mellitus and/or its related metabolic alteration. These results suggest that bone health is clinically significant and should be carefully assessed in diabetes patients.