Two-third of postmenopausal females with type 2 diabetes mellitus (T2DM) exhibited declined TBS along with low bone mass and related with risk of vertebral fracture, revealed by a recently published study of Journal, Menopause.

Previously, the risk of osteoporosis among T2DM patients was unclear but influenced by advanced glycosylation, obesity, insulin effects, hypercalciuria, inflammation, old age etc. the link between osteoporosis and glycemic control also not well understood. This study aimed to evaluate the bone mass status, factors linked to vertebral fracture and microarchitecture factors related to the vertebral fracture among postmenopausal women with T2DM.

The study involved females of age 60.7 ± 6.9 y and went through dual-energy x-ray absorptiometry for the trabecular bone score (TBS), and bone mineral density (BMD) assessment; interviews associated with clinical risk factors (based on FRAX); laboratory evaluation and T8-S1 lateral spine radiographs. A total of 72.6% and 63.2% of women presented diminished bone microarchitecture and low bone mass, respectively. The factors associated significantly with TBS were the femoral neck, lumbar spine, and total hip BMD. bone-specific alkaline phosphatase, vertebral fracture, and age showed a considerable difference among the groups with several T scores or those distributed by TBS groups.

The groups involving osteopenia, normal BMD and osteoporosis exhibited a notable difference in TBS. Further, a direct association was noticed between glycated haemoglobin and bone-specific alkaline phosphatase. However, with TBS and BMD, bone-specific alkaline phosphatase showed an inverse relationship. The relationship between vertebral fracture and BMD was weaker as compared to TBS, TBS and BMD, FRAX and TBS-adjusted FRAX. As per the outcomes, poor glycemic control plays an essential role in bone remodelling.

The authors stated, “The clinical risk factors along with bone strength showed a robust relationship with fracture and may beneficial to recognise females with T2DM at riskof fractures.”