Obese diabetics had low vitamin D and spine fractures – June 2013

Spinal deformity index in patients with type 2 diabetes.

Endocrine. 2013 Jun;43(3):651-8. doi: 10.1007/s12020-012-9848-z. Epub 2012 Dec 11.
Di Somma C, Rubino M, Faggiano A, Vuolo L, Contaldi P, Tafuri N, Andretti M, Savastano S, Colao A.
SDN Foundation Naples, Naples, Italy. cdisomma@unina.it

The objective of this study is to investigate bone metabolism, density, and quality in patients with diabetes type 2 using DEXA and spinal deformity index (SDI), a surrogate index of bone quality. Fifty-six patients with type 2 diabetes were studied; exclusion criteria were diseases and medications that affect bone and mineral metabolism.

  • Mean age was 65 ± 7 years.
  • Mean diabetes duration was 10 ± 7 years and
  • mean HbA1C was 6.6 ± 0.5 %.
  • BMI was 30 ± 4. (VitaminDWiki comment = Obese)

Fifty-six sex, age, and BMI matched served as controls. All subjects underwent a clinical and biochemical examination. Spinal and femoral neck BMD were measured by DEXA, and a spine radiography was performed to assess vertebral fractures and to calculate SDI.
Mean serum 25-OH vitamin D levels were

  • 19.6 ± 3.7 ng/ml in patients and
  • 30 ± 14 ng/ml in controls (p < 0.01).

PTH serum levels were 47.9 ± 40 pg/ml in patients versus 37 ± 5.3 pg/ml in controls (p < 0.01). At lumbar spine there was a significant difference between patients and controls only for T-score (p = <0.01), while at femoral neck there was a difference in BMD (p < 0.01) and in T-score (p < 0.01).
Radiological vertebral fractures were found in

  • 46 % of patients and
  • 17 % of controls (p < 0.05).

SDI was higher in patients than in controls (p < 0.05).
The percentage of fractures with T-score BMD greater than -2.5 was 69 % in patients and 10 % in controls (p < 0.05).
As a conclusion, BMD was similar in patients and in controls, while SDI value was higher in patients; therefore, SDI was more specific than BMD for the diagnosis of osteoporosis due to metabolic diseases.

Comment in: Type 2 diabetes and fractures: more information is needed. [Endocrine. 2013]
PMID: 23229683


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