Assessment of the risk of osteoporotic vertebral fractures of the 2nd and 3rd degree in women in reproductive age and men under 50 with type 1 diabetes mellitus

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Abstract

Rationale: Patients with type 1 diabetes mellitus (DM1) have higher rates of any fractures than those without diabetes. Aim: To identify significant predictors of the osteoporotic vertebral fractures of the 2nd and 3rd degrees and to develop a  statistical model for the risk assessment in DM1 patients. Materials and methods: 97 DM1 patients and 77 control aged below 50 participated in this cross-sectional study. Multiple logistic regressions were used to assess the risk of osteoporotic vertebral fractures of the 2nd and 3rd degrees in DM1 patients. Results: Patients with DM1  had a  statistically significantly lower bone mineral density (BMD) (Z-criterion) in all areas of the axial skeleton, compared to that in the control group (p< 0.001). Osteoporotic vertebral fractures were significantly more frequent (p=0.0385) in DM1 patients than in the controls. The subgroup of DM1  patients with osteoporotic vertebral fractures (n=8) had higher daily insulin requirement per kg of bodyweight compared to that in the subgroup of the patients without fractures (n=89; р=0.029), as well as lower axial BMD (Z-criterion L1–L4, p=0.002; femoral neck Z-criterion, p< 0.001; proximal femoral Z-criterion, p=0.002). We developed a  statistical regression equation model including two parameters: 1) presence or absence of low femoral neck BMD based on the dual X-ray absorptiometry, 2)  daily insulin requirement per kg of bodyweight. Conclusion: The statistical model has the sensitivity of 87% and specificity of 75% to predict that the DM1 patients would have low or high risk of osteoporotic vertebral fractures of the 2nd and 3rd degree.

About the authors

O. V. Vodyanova

Belarusian Medical Academy for Postgraduate Education

Author for correspondence.
Email: olka-vip@tut.by
Postgraduate Student, Chair of Diagnostic Radiology Belarus

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Copyright (c) 2017 Vodyanova O.V.

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