MONTREAL — Loss of bone mineral density over time appears to be more severe in older men with type 2 diabetes than in older men without diabetes, even though men with diabetes have higher average bone mineral density at baseline.
Data from 4 years of follow-up from a prospective study showed that fractures are more likely to occur in older adults with type 2 diabetes than in euglycemic older adults, even though studies have reported that those with type 2 diabetes have 4%–5% higher bone mineral density (BMD) after adjustment for total lean and fat mass. Higher bone loss has been especially noted in older white women with diabetes, especially in those using thiazolidinediones (TZDs), Elsa S. Strotmeyer, Ph.D., said at the annual meeting of the American Society for Bone and Mineral Research.
Dr. Strotmeyer and her associates based their investigation on men in the Osteoporotic Fractures in Men (MrOS) study, which involved osteoporosis screening initially in 2000–2002 and a follow-up exam 4 years later of 5,995 ambulatory, community-dwelling men older than 65 years. The researchers examined dual x-ray absorptiometry exams from 4,094 of these men, who had a mean age of 73 years. Most of them were white (91%), and some had type 2 diabetes (14%) or impaired fasting glucose (IFG, 37%).
Men with diabetes had higher mean BMD at baseline (0.986 g/cm
Despite their greater overall mean BMD, men with diabetes experienced a significantly greater annual decline in BMD at the femoral neck than did the other men. This yearly decrease (−0.562%) occurred at nearly twice the rate seen in men with IFG (−0.313%) or normal fasting glucose (−0.325%).
At the end of follow-up, the bone area of men with diabetes had increased significantly more than in the other men. The men with diabetes also showed a greater loss of bone mineral content, although there was not a statistically significant difference among the groups. This meant that men with diabetes with the lowest bone area at baseline actually had the greatest gain in bone area during the study.
The study received funding from several institutes in the National Institutes of Health.