International Journal of Advances in Medicine | September 2020 | Vol 7 | Issue 9 Page 1380
International Journal of Advances in Medicine
Reema N et al. Int J Adv Med. 2020 Sep;7(9):1380-1387
http://www.ijmedicine.com
pISSN 2349-3925 | eISSN 2349-3933
Original Research Article
A study of magnitude and correlates of altered bone mineral density in
type 2 diabetes mellitus patients of central rural India
Ningthoukhongjam Reema
1
, Jyoti Jain
2
*, Thangjam Gautam Singh
3
, Shashank Banait
4
INTRODUCTION
Diabetes mellitus (DM) is fast becoming the epidemic of
the 21
st
century. India has earned the dubious distinction
of “diabetes capital of World” with highest prevalence in
World (62 million).
1,2
The metabolic dysregulation
associated with DM causes patho-physiologic changes in
almost all organ system in the body including bone
metabolism and bone mass.
1-3
Causes of such changes are
multifactorial and complex. Hyperglycemia increases
osteoclast function but decreases osteoblast function,
thereby leading to accelerated bone loss, osteopenia and
osteoporosis. Bone loss may further be aggrevated by a
decrease in neovascularization and other is advanced
glycated end products (AGEs), which may eventually
result in low-impact or fragility fractures.
4
Subsequently
BMD is reduced in T2DM.
5
Bone mineral density (BMD)
identifies osteopenia, osteoporosis and can predict
ABSTRACT
Background: Diabetes mellitus is fast becoming the epidemic of the 21
st
century. It is a metabolic disease that affects
multiple organ system in the body including bone metabolism and bone mass. There is high prevalence of decreased
bone mineral density (BMD) in type 2 diabetes mellitus (T2DM) patients leading to osteoporosis, osteopenia and
fracture. The aim of the present study was to find the magnitude and correlates of altered BMD in T2DM patients of
central rural India.
Methods: This cross-sectional study was carried out at a tertiary care teaching hospital in central rural India from
2014 to 2016. It comprises of 200 T2DM patients with aged ≥35 years. Bone mineral density measurements were
done by using peripheral dual energy x-ray absorptiometry (DEXA).
Results: Mean age of study subjects was 56.13±11.12 years with 43.5% males and 56.5% females. Our study results
showed the magnitude of decreased BMD was 82%. 53% of the study subjects were osteoporotic and 29% were
osteopenic. Significant associations were detected between decreased BMD and old age, female gender, high body
mass index, high fasting blood sugar, high HbA1c and low serum calcium on multivariate analysis.
Conclusions: The prevalence of decreased BMD in patients with T2DM of central rural India is high, especially in
females’ patients, obese patients, and uncontrolled diabetic patients. Awareness amongst the health care provider of
this changes will directly affect the treatment decisions for patients, thereby preventing osteoporosis, osteopenia and
mitigating potential fracture risk.
Keywords: Bone mineral density, DEXA, Osteoporosis, Type II diabetes mellitus
1
Department of Medicine, RIMS, Imphal, Manipur, India
2
Department of Medicine, Mahatma Gandhi institute of Medical Sciences (MGIMS), Sewagram, Wardha,
Maharashtra, India
3
Department of Radiodiagnosis, Shija Hospitals, Imphal, Manipur, India
4
Department of Opthalmology, JNMC, Sawangi, Maharashtra, India
Received: 28 June 2020
Accepted: 30 July 2020
*Correspondence:
Dr. Jyoti Jain,
E-mail: jyotisewagram@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2349-3933.ijam20203603