In:
PLOS ONE, Public Library of Science (PLoS), Vol. 15, No. 11 ( 2020-11-19), p. e0241616-
Abstract:
Studies show trabecular bone score (TBS) may provide information regarding bone quality independent of bone mineral density (BMD) in type 2 diabetes (DM2) patients. We analyzed our Southeast Asian severe osteoporotic hip fracture patients to study these differences. Methods We conducted a retrospective cross-sectional analysis of subjects admitted to Changi General Hospital, Singapore with severe osteoporotic hip fractures from 2014–2017 who had BMD performed. Electronic records were reviewed and subjects were classified as having diabetes according to the WHO 2019 criteria. DM2 patients were classified according to their HbA1c into well controlled (HbA1c 〈 7%) and poorly controlled (HbA1c ≥ 7%) DM2. Results Elderly patients with hip fractures present with average femur neck T scores at the osteoporotic range, however those with DM2 had higher BMD and TBS values compared to non DM2 patients. These differences were statistically significant in elderly women—poorly controlled elderly DM2 women with hip fracture had the highest total hip T-score (-2.57 ± 0.86) vs (-2.76 ± 0.96) in well controlled DM2 and (-3.09 ± 1.01) in non DM2 women with hip fracture, p 〈 0.001. In contrast, TBS scores were lower in poorly controlled DM2 women with hip fracture compared to well controlled DM2 women with hip fracture (1.22 ± 0.11) vs (1.24 ± 0.09), but these were still significantly higher compared to non DM2 women with hip fracture (1.19 ± 0.10), p 〈 0.001. In elderly men with hip fractures, univariate analysis showed no statistically significant differences in TBS or hip or LS BMD between those with poorly controlled DM2, well controlled DM2 and non DM2. The differences in TBS and BMD remained significant in all DM2 women with hip fractures even after adjustments for potential confounders. Differences in TBS and BMD in poorly controlled DM2 men with hip fractures only became significant after accounting for potential confounders. However, upon inclusion of LS BMD into the multivariate model these differences were attenuated and remained significant only between elderly women with well controlled DM2 and non DM2 women with hip fractures. Conclusions Elderly patients with DM2 and severe osteoporosis present with hip fractures at a higher BMD and TBS values compared to non DM2 patients. These differences were significant after adjustment for confounders in all DM2 women and poorly controlled DM2 men with hip fractures, TBS differences were attenuated with the inclusion LS BMD. Further studies are needed to ascertain differences in BMD and TBS in older Southeast Asian DM2 patients with variable glycemic control and severe osteoporosis.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0241616
DOI:
10.1371/journal.pone.0241616.g001
DOI:
10.1371/journal.pone.0241616.t001
DOI:
10.1371/journal.pone.0241616.t002
DOI:
10.1371/journal.pone.0241616.t003
DOI:
10.1371/journal.pone.0241616.s001
DOI:
10.1371/journal.pone.0241616.s002
DOI:
10.1371/journal.pone.0241616.s003
DOI:
10.1371/journal.pone.0241616.s004
DOI:
10.1371/journal.pone.0241616.s005
DOI:
10.1371/journal.pone.0241616.s006
DOI:
10.1371/journal.pone.0241616.s007
DOI:
10.1371/journal.pone.0241616.s008
DOI:
10.1371/journal.pone.0241616.s009
DOI:
10.1371/journal.pone.0241616.s010
DOI:
10.1371/journal.pone.0241616.r001
DOI:
10.1371/journal.pone.0241616.r002
DOI:
10.1371/journal.pone.0241616.r003
DOI:
10.1371/journal.pone.0241616.r004
DOI:
10.1371/journal.pone.0241616.r005
DOI:
10.1371/journal.pone.0241616.r006
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2020
detail.hit.zdb_id:
2267670-3
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