Session: SAT 248-267-Osteoporosis II
Poster Board SAT-259
From 2007-2012 we studied 218 patients with Type 2 Diabetes (Type 2 DM), 166 women, 52 men in a cross-sectional design via chart review. Patients were 65.6% Hispanic, 28% Black, 4.6% White, and 1.8% Asian. 49.3% were taking pioglitazone (P). Mean duration of diabetes was 7.76+1.96 years. The two groups were quite comparable in terms of age, BMI, A1c, Vitamin D, and PTH levels. We compared absolute mean BMD and t-score at the lumbar spine, total hip and femoral neck in the 2 groups by unpaired t-test and then corrected for possibly confounding variables by multiple regression analysis using SPSS.
After correction, absolute mean BMD was significantly lower in P users only at the femoral neck p=0.16. Black patients had significantly higher mean BMD for the total hip than patients from other backgrounds p=0.02. Serum estrone was significantly, negatively correlated with patient age p=0.006. Serum estradiol was significantly correlated with patient BMI p=0.01. Serum androstenedione was significantly, negatively correlated with patient age p=0.038. Serum total and free testosterone were significantly, negatively correlated with patient BMI, p=0.12, p=0.004 respectively. Sex hormone binding globulin was significantly, negatively correlated with HbA1c p=0.035. T-score at total hip was significantly lower in P users p=0.015, was negatively correlated with patient age p=0.009, positively correlated with BMI p<0.001, and was higher in Black patients than in other groups p=0.001. T-score in the lumbar spine was significantly lower in P users p=0.026 and was higher in Black patients p=0.01.
- In this largely Hispanic and Black cohort P use was associated with modestly lower BMD that may be mitigated by concurrent use of metformin, insulin, hydrochlorothiazide, and/or sulfonylureas, and offset by increasing BMI.
- The observed mitigating effect of increasing BMI may be partially explained by the association of BMI with estradiol.
- Black patients are relatively protected in terms of absolute BMD at total hip and t-score at the lumbar spine.
Nothing to Disclose: MA, TN, GB, SIM, ASS
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