Prevalence and associated factors of metabolic bone disease in male with type 2 diabetes mellitus / Dr. Hanis Rabeah Kamaruzaman

INTRODUCTION Postmenopausal women and people over the age of 70 are more likely to develop osteoporosis. It is recognized as significant comorbidity among those with type 2 diabetes mellitus (T2DM), and male fractures are on the rise with higher rates of mortality than women (37.5% vs 28.2% respectively). However, there is a scarcity of data linking T2DM and metabolic bone disease in men. OBJECTIVE Our study aimed to determine the prevalence of metabolic bone diseases, including osteoporosis and osteopenia, and the associated factors, bone turnover markers, and vitamin D in male with T2DM.
METHOD This is a cross-sectional, single-centre study in men above 50 years of age with T2DM, conducted from December 2021 to June 2022. Demographic data, baseline comorbidities, and biochemical profiles including urine albumin-creatinine ratio (UACR) were obtained. Bone turnover markers including C-terminal telopeptide of type I collagen (CTX) and bone-specific alkaline phosphates (bsALP) were measured. Osteoporosis and osteopenia were determined by Dual Energy X- ray Absorptiometry (DEXA).
RESULT 148 male with T2DM with a median age of 64 (IqR 11) years was recruited. The prevalence of metabolic bone disease in the study population was 20.3%. Multivariate analysis shows total bilirubin level [OR: 1.13 (95% CI: 1.050, 1.223) p<0.001], high intact parathyroid hormone (iPTH) level ≥6.9 pmol/L [OR 3.05 (95% CI: 1.141, 8.187), p=0.026] and use of dipeptidyl peptidase-4 inhibitor (DPP4i) [OR 0.274 (95% CI: 0.093, 0.809) p=0.01] are predictors of metabolic bone disease in the study population.
CONCLUSION Metabolic bone disease affects about 1 in 5 men with T2DM patients, This study underscores the importance of screening for metabolic bone disease in men T2DM with high total bilirubin and high iPTH level to allow early detection, initiation of treatment and other preventive measures. There is need for further study looking at association of DPP4i with metabolic bone disease