Bone Mineral Density in Egyptian Patients with Type 1 Diabetes Mellitus

Abstract Background: Osteoporosis is the most common of all metabolic bone diseases, and represents a major public health problem as it is associated with increased mortality, morbidity, and health care costs. Osteoporosis is not a single entity, but rather a pathological state with many causes. Attention has been recently focused on diabetic bone pathology, as the prevalence of diabetes mellitus is increasing rapidly in the population, with the implication that adverse outcomes of the condition are likely to grow in importance. Aim of Work: This study was designed to study the effect of type 1 diabetes mellitus and associated factors (such as BMI, diabetes duration, diabetes control, some metabolic bone markers and average daily calcium intake) on bone mineral density. Subjects and Methods: The study was carried out on 60 young individuals; 40 patients with type 1 diabetes and 20 normal healthy individuals served as a control group. All patients and controls were subjected to full history taking, thorough clinical examination, estimation of fasting blood glucose, HbAl c, kidney and liver functions, some biochemical bone markers as Serum calcium, Phosphorus, and alkaline phosphatase level and Assessment of Bone Mineral Density (BMD) by Ultrasonic Bone Imaging Scanner 3000 (UBIS 3 000). Results: There were significantly higher Fasting and postprandial blood glucose, HbAl c, serum alkaline phos-phatase, and serum phosphorus level among the diabetic group compared to the control subjects. Serum calcium level was significantly lower among the diabetic group compared to the control subjects. As regards Bone Mineral Density (BMD) parameters; BUA, T-score and Z-score (which are calculated from BUA), were significantly lower among the diabetic group compared to the control subjects, while Rhelative Risk of Fracture (RRF) was significantly higher among the diabetic group compared to the control subjects. In all type 1 diabetic patients there was a highly significant positive correlation between T-score, Z-score and BUA (p<0.01). There were Correspondence to: Dr. Zeinab A. Hasan, E-mail: zehasan@gmail. com positive correlations between T-score, Z-score and BUA with age, weight, BMI, and average Daily Calcium intake, and negative correlation between T-score, Z-score and BUA with relative risk fracture, serum alkaline phosphatase and HBAlc in all type 1 diabetic patients. In all studied groups there was no significant correlation between serum calcium level with average Daily Ca intake. The percentage of osteoporosis and osteopenia was higher among the diabetic group compared to the control subjects. Conclusions: The present study showed that Typeldiabetes mellitus is associated with osteopenia and osteoporosis along with increase in fracture risk. Diabetes control, average Daily Calcium intake and BMI are major determinants in occurrence of osteoporosis, as the percentage of the disease increases in poorly controlled patients, those with decreased daily calcium intake and low weight. Serum calcium and phosphorus levels have no value in the diagnosis of osteoporosis. Key Words: Type-1 diabetes — Bone mineral density — Os-teopenia — Osteoporosis.