Background
Methods
Patients
Methods
Statistical analysis
Results
Type 1 diabetes mellitus (n = 139) | Type 2 diabetes mellitus (n = 243) | Control group (n = 504) | ||||
---|---|---|---|---|---|---|
Men (n = 71) | Women (n = 68) | Men (n = 115) | Women (n = 128) | Men (n = 255) | Women (n = 249) | |
Mean ± SD (Min. - max.) | Mean ± SD (Min. - max.) | Mean ± SD (Min. - max.) | Mean ± SD (Min. - max.) | Mean ± SD (Min. - max.) | Mean ± SD (Min. - max.) | |
Age (years) | 42.0 ± 12.9* | 45.8 ± 13.0* | 62.7 ± 8.5 | 62.9 ± 8.5 | 64.9 ± 8.4# | 64.1 ± 8.0 |
(17–42) | (22–79) | (37–83) | (28–87) | (51–82) | (51–81) | |
BMI (g/cm2) | 25.2 ± 3.3* | 24.6 ± 2.9* | 28.9 ± 4.5 | 29.7 ± 5.3 | 27.6 ± 3.5## | 26.9 ± 4.5## |
(15.9–24.8) | (18.9–32.0) | (21.6–47.8) | (18.9–47.3) | (19–45) | (16.8–42.1) | |
Age at menopause | - |
(n = 13)
| - |
(n = 84)
|
-
|
(n = 198)
|
41.4 ± 6.2 | 46.6 ± 7.2 | 49.9 ± 4.7 | ||||
(30–52) | (27–58) | (32–60) | ||||
Systolic blood pressure | 127.8 ± 18.6 | 123.0 ± 17.2 | 136.8 ± 19.4 | 135.6 ± 21.1 | ||
(85–175) | (90–125) | (100–225) | (80–190) | |||
Diastolic blood pressure | 74.9 ± 10.7 | 71.4 ± 10.2 | 76.2 ± 11.2 | 73.2 ± 11.9 | ||
(45–75) | (55–95) | (50.0–110.) | (45–110) | |||
Diabetes specific parameters
| ||||||
Age at first diagnosis of diabetes | 26.4 ± 10.2* | 25.1 ± 11.1* | 51.9 ± 9.4 | 51.3 ± 11.9 | ||
(8–53) | (1–55) | (31–75) | (20–80) | |||
Duration of diabetes (years) | 15.6 ± 12.0** | 20.7 ± 12.2* | 12 ± 9 | 11 ± 8 | ||
(0.2–44.0) | (0.4–46.2) | (0–34) | (0–33) | |||
HbA1c | 7.09 ± 1.17 | 7.15 ± 1.07 | 7.22 ± 1.34 | 7.26 ± 1.19 | ||
(5.3–10.4) | (4.7–10.4) | (4.8–11.4) | (4.9–11.1) | |||
Diabetes therapy
|
n (%)
|
n (%)
|
n (%)
|
n (%)
| ||
Diet or oral antidiabetics | 50 (43.5) | 59 (46.1) | ||||
Insulin | 71 100.0) | 68 (100.0) | 65 (56.5) | 69 (53.9) | ||
Microvascular complications
| ||||||
Retinopathy
|
(n = 69)
|
(n = 68)
|
(n = 111)
|
(n = 126)
| ||
No | 41 (59.4) | 42 (61.8) | 86 (77.5) | 86 (68.2) | ||
Yes | 28 (40.6) | 26 (38.2) | 25 (22.5) | 40 (31.8) | ||
Polyneuropathy
|
(n = 70)
|
(n = 67)
|
(n = 115)
|
(n = 128)
| ||
No | 49 (70) | 47 (70.2) | 48 (41.7) | 63 (49.2) | ||
Yes | 21 (30) | 20 (29.8) | 67 (58.3) | 65 (50.8) | ||
Nephropathy
|
(n = 71)
|
(n = 68)
|
(n = 106)
|
(n = 116)
| ||
Normal | 50 (70.4) | 55 (80.9) | 61 (57.6) | 81 (69.8) | ||
Microalbuminuria | 15 (21.1) | 12 (17.7) | 35 (33.0) | 26 (22.4) | ||
Macroalbuminuria | 6 (8.5) | 1 (1.4) | 10 (9.4) | 9 (7.8) | ||
Macrovascular complications
| ||||||
Coronary heart disease
|
(n = 66)
|
(n = 65)
|
(n = 108)
|
(n = 123)
| ||
No | 58 (87.9) | 60 (92.3) | 77 (71.3) | 100 (81.3) | ||
Yes | 8 (12.1) | 5 (7.7) | 31 (28.7) | 23 (18.7) | ||
Myocardial infarction
| 6 (8.5) | 2 (2.9) | 24 (20.9) | 16 (12.5) | ||
Cerebrovascular disease
| ||||||
(Stroke, TIA, PRIND) | 2 (2.9) | 0 (0) | 6 (5.2) | 7 (5.5) | ||
Peripheral artery disease
|
(n = 68)
|
(n = 68)
|
(n = 111)
|
(n = 124)
| ||
No | 62 (91.2) | 63 (92.6) | 91 (82.0) | 105 (84.7) | ||
Yes | 6 (8.8) | 5 (7.4) | 20 (18.0) | 19 (15.3) | ||
Hypertension
| ||||||
yes | 27 (38.0) | 21 (30.9) | 83 (72.2) | 97 (75.8) |
Distribution of BMD in patients with type 1 and type 2 diabetes
Men | |||||
---|---|---|---|---|---|
Type 1 n = 71 | Type 2 n = 115 | Control n = 255 | Type 1 vs. type 2 | Type 2 vs. control | |
BMD
| Mean ± SD | Mean ± SD | Mean ± SD | p-value | p-value |
Lumbar BMD (g/cm2) | 1.05 ± 0. 14 | 1.08 ± 0.18 | 1.03 ± 0.20 | 0.263 | 0.03 |
Femoral Neck BMD (g/cm2) | 0.84 ± 0.12 | 0.88 ± 0.15 | 0.81 ± 0.13 | 0.079 | 0.0001 |
T-Score (SD) Lumbar BMD | −0.56 ± 1.34 | −0.31 ± 1.61 | −0.76 ± 1.78 | 0.268 | 0.017 |
T-Score (SD) Femoral Neck BMD | −1.20 ± 1.11 | −0.90 ± 1.39 | −1.55 ± 1.24 | 0.104 | 0.0001 |
Adjusted BMD*
| LSMEAN ± SE | LSMEAN ± SE | LSMEAN ± SE | ||
Lumbar BMD (g/cm2) | 1.05 ± 0.03 | 1. 08 ± 0.02 | 1.03 ± 0.01 | 0.453 | 0.027 |
Femoral Neck (g/cm2) | 0.83 ± 0.02 | 0. 88 ± 0.02 | 0.81 ± 0.01 | 0.11 | 0.0011 |
WHO-criteria
|
% (n)
|
% (n)
|
% (n)
| ||
Lumbar BMD T-score
| |||||
<−2.5 SD (Osteoporosis) | 5.6 (4) | 6.1 (7) | 14.9 (38) | ||
−2.5 SD – −1.0 SD (Osteopenia) | 31.0 (22) | 30.4 (35) | 32.9 (84) | ||
>−1.0 SD (Normal) | 63.4 (45) | 63.5 (73) | 52.2 (133) | ||
WHO-criteria
| |||||
Femoral Neck BMD T-score
| |||||
<−2.5 SD (Osteoporosis) | 9.9 (7) | 13.0 (15) | 21.2 (54) | ||
−2.5 SD – −1.0 SD (Osteopenia) | 45.1 (32) | 35.7 (41) | 49.8 (127) | ||
>−1.0 SD (Normal) | 45.1 (32) | 51.3 (59) | 29.0 (74) |
Women | |||||
---|---|---|---|---|---|
Type 1 n = 68 | Type 2 n = 128 | Control n = 249 | Type 1 vs. type 2 | Type 2 vs. control | |
BMD
| Mean ± SD | Mean ± SD | Mean ± SD | p-value | p-value |
Lumbar BMD (g/cm2) | 1.03 ± 0.15 | 1.02 ± 0.17 | 0.90 ± 0.18 | 0.733 | 0.0001 |
Femoral Neck BMD (g/cm2) | 0.80 ± 0.12 | 0.79 ± 0.16 | 0.70 ± 0.12 | 0.940 | 0.0001 |
T-Score (SD) Lumbar BMD | −0.45 ± 1.37 | −0.46 ± 1.56 | −1.65 ± 1.53 | 0.974 | 0.0001 |
T-Score (SD) Femoral Neck BMD | −1.01 ± 1.15 | −0.95 ± 1.57 | −1.96 ± 1.13 | 0.772 | 0.0001 |
Adjusted BMD*
| LSMEAN ± SE | LSMEAN ± SE | LSMEAN ± SE | ||
Lumbar BMD (g/cm2) | 1.01 ± 0.03 | 1.05 ± 0.01 | 0.91 ± 0.01 | 0.337 | 0.0001 |
Femoral Neck (g/cm2) | 0.78 ± 0.02 | 0.80 ± 0.01 | 0.71 ± 0.01 | 0.560 | 0.0001 |
WHO-criteria
|
% (n)
|
% (n)
|
% (n)
| ||
Lumbar BMD T-score
| |||||
<−2.5 SD (Osteoporosis) | 5.9 (4) | 9.4 (12) | 26.9 (67) | ||
−2.5 SD – −1.0 SD (Osteopenia) | 29.4 (20) | 27.3 (35) | 42.6 (108) | ||
>−1.0 SD (Normal) | 64.7 (44) | 63.3 (81) | 30.5 (76) | ||
WHO-criteria
| |||||
Femoral Neck BMD T-score
| |||||
<−2.5 SD (Osteoporosis) | 10.3 (7) | 21.9 (28) | 32.1 (80) | ||
−2.5 SD – −1.0 SD (Osteopenia) | 41.2 (28) | 31.2 (40) | 45.8 (114) | ||
>−1.0 SD (Normal) | 48.5 (33) | 46.9 (60) | 22.1 (55) |
Prevalence of osteoporosis in patients with diabetes compared with the control group
Determinants of BMD in patients with type 1 and type 2 diabetes
Diabetes mellitus type 1 | ||||
---|---|---|---|---|
Dependent variable: lumbar BMD | Dependent variable: femoral neck BMD | |||
Parameter estimate; SE | p-value | Parameter estimate; SE | p-value | |
Gender (women vs. men) | 0.0050; 0.02 | 0.84 | −0.019; 0.02 | 0.32 |
Age | −0.0025; 0.001 | 0.04 | −0.003; 0.0009 | 0.0004 |
Duration of diabetes | −0.0009; 0.001 | 0.51 | −0.0009; 0.001 | 0.51 |
BMI | 0.013; 0.004 | 0.001 | 0.011; 0.003 | 0.0003 |
Presence of micro- or macrovascular complications | 0.004; 0.03 | 0.88 | 0.022; 0.02 | 0.38 |
HbA1c | −0.02; 0.01 | 0.08 | −0.008; 0.008 | 0.37 |
Diabetes mellitus type 2
| ||||
Dependent variable:
lumbar BMD
|
Dependent variable:
femoral neck BMD
| |||
Parameter estimate; SE
|
p-value
|
Parameter estimate; SE
|
p-value
| |
Gender (women vs. men) | −0.05; 0.02 | 0.02 | −0.079; 0.02 | 0.0001 |
Age | −0.003; 0.001 | 0.02 | −0.003; 0.001 | 0.001 |
Duration of diabetes | 0.004; 0.001 | 0.01 | 0.00047; 0.001 | 0.704 |
BMI | 0.007; 0.002 | 0.002 | 0.010; 0.002 | 0.0001 |
Presence of micro- or macrovascular complications | −0.0006; 0.03 | 0.98 | −0.016; 0.02 | 0.51 |
HbA1c | −0.0126; 0.008 | 0.15 | −0.01; 0.007 | 0.14 |