Risk Factors for Ten-Year Risk of Osteoporosis in type 2 DM Patients Attending Tikur Anbessa Specialized Hospital Diabetic Center-Crosssectional Study
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Date
2024-04-03
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Addis Ababa University
Abstract
Background. Osteoporosis is characterized by decreased bone density and microarchitectural changes which lead to fragility fractures. Type 2 diabetes mellites is also exposed to fragility fractures by interfering with the metabolism of carbohydrates, fats, and proteins. It also dysregulates calcium, phosphorus, and magnesium metabolisms.
Objective The purpose of this study was to assess the risk of high risk of fragility fractures and factors associated with increased risk of 10-year osteoporotic fracture in patients with type 2 diabetes mellites. Methods Data was collected from 175 patients aged >40(the fracture assessment tool includes individuals above 40 years). ears) with type 2 diabetes mellites attending black lion specialized teaching hospital diabetes and endocrine clinics by a structured questionnaire. Diabetic complications, hemoglobin A1c, fasting blood sugar, and other medical diagnoses included in the questionnaire were collected from the electronic medical record system based on the medical record number. Fracture risk was calculated for all patients using the FRAX tool, Ethiopia; bone mineral density was not used. The data was coded and entered SPSS version 26, and factors associated with osteoporotic fractures were explored using a logistic regression model.
Results Of the 175 patients who participated in the study, 88 (50.3%) were females, and the median (IQR) age was 60 (52-66) years. 134 (76.6%) were Orthodox Christians and 20 (11.4%) were Muslims. Most patients (74.3%) were married, and 78 (44.6%) had attended college and above. Most patients (85.1%) were from Addis Ababa, and almost all (97.1) lived in an urban setup. 68 (38.9%) were government employees, and the median monthly income of the participants was 5000 (30008000) ETB. The median (IQR) duration of diabetes was 11(6-20) years. The median (IQR) FRAX score for the 10-year probability of a hip fracture ≥ 3% and a 10-year probability of a major osteoporosis-related fracture ≥ 20% were 1.5 (0.5-3.3) and 7.8 (3.0-10.0), respectively. The overall prevalence of a 10-year risk of osteoporotic fracture in this study is 30.9%. The median (IQR) levels of HgA1c and FBS were 8.0 (7.0-9.4) and 150 (125-192), respectively. Macrovascular complications occurred in 137 (78.3%) patients, while neuropathy,retinopathy, and nephropathy were seen in 143 (81.7%), 140 (80.0%), and 126 (72.0%) patients, respectively. FBS (AOR, 1.01; 95% CI, 1.00-1.02; P= 0.011), higher HgA1c (AOR, 1.45; 95% CI, 1.11-1.88; P= 0.006), and presence of macrovascular complications (AOR, 2.73; 95% CI, 1.12-6.66; P= 0.027) are significantly associated with increased fragility fractures.
Conclusion: In our study, the combined (hip, MOF), the prevalence of ten-year risk of osteoporosis in type 2 DM was 30.9%, and higher HGA1C, FBS, and macrovascular complications were significantly associated with increased ten-year risk of osteoporosis and fragility fractures.
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osteoporosis in type 2 DM patients