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. 2021 Nov 24;65(6):801-810.
doi: 10.20945/2359-3997000000418. Epub 2021 Nov 11.

Osteosarcopenia and trabecular bone score in patients with type 2 diabetes mellitus

Luciana Muniz Pechmann  1 , Ricardo R Petterle  2 , Carolina A Moreira  3 , Victoria Z C Borba  3
Affiliations

Osteosarcopenia and trabecular bone score in patients with type 2 diabetes mellitus

Luciana Muniz Pechmann et al. Arch Endocrinol Metab. .

Abstract

Objective: To evaluate the prevalence of osteosarcopenia and the association of osteosarcopenia with trabecular bone score (TBS) in a group of patients with type 2 diabetes mellitus(T2DMG) compared with a paired control group (CG).

Methods: Cross-sectional study with men and women ≥ 50 years recruited by convenience. Patients in both groups answered questionnaires and underwent evaluation of bone mineral density (BMD), handgrip strength (HGS), and TBS. The T2DMG also underwent a gait speed (GS) test. Sarcopenia was defined as low lean mass plus low HGS or GS according to the Foundation for the National Institute of Health Sarcopenia Project, and osteosarcopenia was deemed present when sarcopenia was associated with osteopenia, osteoporosis, or low-energy trauma fractures.

Results: The T2DMG (n = 177) and CG (n = 146) had, respectively, mean ages of 65.1 ± 8.2 years and 68.8 ± 11.0 years and 114 (64.4%) and 80 (54.7%) women. T2DMG versus the CG had higher rates of osteosarcopenia (11.9% versus 2.14%, respectively, p = 0.010), sarcopenia (12.9% versus 5.4%, respectively, p < 0.030), and fractures (29.9% versus 18.5%, respectively, p = 0.019), and lower HGS values (24.4 ± 10.3 kg versus 30.9 ± 9.15 kg, respectively, p < 0.001), but comparable BMD values. Mean TBS values were 1.272 ± 0.11 and 1.320 ± 0.12, respectively (p = 0.001). On multivariate analysis, age, greater waist circumference, fractures, and osteoporosis increased the risk of degraded TBS. Osteosarcopenia was associated with diabetes complications (p = 0.03), calcium and vitamin D supplementation (p = 0.01), and all components of osteosarcopenia diagnosis (p < 0.05).

Conclusion: Compared with the CG, the T2DMG had a higher prevalence of osteosarcopenia, sarcopenia, and fractures and lower bone quality assessed by TBS.

Keywords: Sarcopenia; fractures; muscle weakness; osteoporosis; type 2 diabetes mellitus.

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Conflict of interest statement

Disclosure: no potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1. Flowchart of the selection process of patients included in the type 2 diabetes mellitus (T2DM) group.
Figure 2
Figure 2. Trabecular bone score in T2DM patients and controls with and without a history of fractures. T2DMG: type 2 diabetes mellitus group; CG: control group.
Figure 3
Figure 3. Bone mineral density in both groups. BMD: bone mineral density; T2DMG: type 2 diabetes mellitus group; CG: control group; FN: femoral neck; TH: total hip; L1-L4: lumbar spine 1 to 4.
Figure 4
Figure 4. Prevalence of osteopenia, osteoporosis and osteosarcopenia. T2DMG: type 2 diabetes mellitus group; CG: control group; BMD: bone mineral density.
See this image and copyright information in PMC

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