Association between diabetes mellitus and trochanteric bone mineral density in individuals with osteoporotic fractures: a retrospective study

Shao-Han Guo; Jian Xu; Min-Zhe Xu; Chong Li; Ya-Qin Gong; Ke Lu

doi:10.3389/fmed.2024.1492603

Association between diabetes mellitus and trochanteric bone mineral density in individuals with osteoporotic fractures: a retrospective study

Front Med (Lausanne). 2024 Dec 17:11:1492603. doi: 10.3389/fmed.2024.1492603. eCollection 2024.

Authors

Shao-Han Guo¹, Jian Xu², Min-Zhe Xu¹, Chong Li¹, Ya-Qin Gong³, Ke Lu¹

Affiliations

¹ Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China.
² Department of Orthopedics, The First People's Hospital of Kunshan, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China.
³ Information Department, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China.

Abstract

Background: The relationship between diabetes mellitus (DM) and bone mineral density (BMD) in patients with osteoporotic fractures (OPFs) remains complex and heterogeneous, specifically between the genders. This study aimed to explore the association between diabetes status and trochanteric BMD in a cohort of patients with OPFs and elucidate the differences between male and female patients.

Methods: This retrospective analysis was performed on 710 admitted patients aged 50 years or older with OPFs. In this study, the exposure variable was diabetes status. Trochanteric BMD comprised the dependent variable. While controlling for covariance influences, generalized estimating equations (GEE) were applied to examine the independent link between diabetes status and trochanteric BMD in OPFs patients. Moreover, a subgroup analysis was also conducted to validate the result's stability.

Results: A substantial positive association was noted between diabetes status and trochanteric BMD in diabetic patients, as determined by the fully adjusted model (β = 0.017, 95% CI 0.001 to 0.033, p = 0.035). Furthermore, the sex-specific analysis showed a significant positive relationship between diabetes status and trochanteric BMD in male patients (β = 0.040, 95% CI 0.006 to 0.075, p = 0.022), whereas no significant relationship was observed in female patients (β = 0.010, 95% CI -0.008 to 0.028, p = 0.256).

Conclusion: This study highlighted the significant sex differences in the impact of diabetes on trochanteric BMD among patients with OPFs. The male diabetic patients had higher trochanteric BMD than their non-diabetic counterparts; however, this association was not evident in female patients. Further research is necessary to understand the underlying mechanisms that contribute to these sex-specific differences and to evaluate the clinical implications of managing fracture risk in diabetic patients.

Keywords: bone mineral density; diabetes; osteoporotic fractures; retrospective analysis; sex-specific effects.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. The study was supported by China Postdoctoral Science Foundation (CN) (2022M711439), Elderly Health Research Project of Jiangsu Province (CN) (LKZ2022020), Special Funding for Jiangsu Province Science and Technology Plan (Key Research and Development Program for Social Development) (CN) (BE2023738), Suzhou Collaborative Innovation Research Project of Medical and Industrial Integration (CN) (SLJ2022023), Suzhou Key Clinical Diagnosis and Treatment Technology Project (CN) (LCZX202024), and Postgraduate Research & Practice Innovation Program of Jiangsu Province (CN) (SJCX24_2446).