RESUMEN
This study was conducted to evaluate prevalence and risk factors for diagnostic discordance for osteoporosis due to different T-scores of lumbar spine and femoral neck. In this cross sectional study demographic, anthropometric and risk factors for osteoporosis were derived from a database on 3,039 post-menopausal women who underwent bone densitometry for the first time in our department [Kurdistan Nuclear Medicine Center] from 2003 to 2010. DXA was performed on L2-L4 vertebrae and femoral neck for all cases. Major discordance [one site osteoporotic and the other normal] and minor discordance [difference between two site no more than one WHO diagnostic class] were determined. The association of related risk factors with discordance of interest was assessed. Prevalence of osteoporosis and osteopenia in these post-menopausal women with mean age of 58.5 +/- 8.7 years, menopausal period of 11.2+9.4 years and mean BMI of 28+4.5 were 37.7% and 50.7%, respectively. Frequencies of minor and major discordances were 40.0% and 1.8%, respectively. The minor discordance was a common finding; however, the major discordance is uncommon. The most important risk factors for major discordance were age, menopausal duration and BMI. There was no significant relationship between other risk factors [smoking and history of bone fracture] and diagnostic T-score discordances
RESUMEN
Diabetes mellitus and osteoporosis are two frequent medical conditions with an increasing prevalence in elderly. This study is conducted to evaluate osteoporosis in postmenopausal females with type 2 diabetes mellitus in Sanandaj, the provincial center of Kurdistan province in the west of Iran. From an initial population of 2500 women with type 2 diabetes, 242 postmenopausal women were randomly selected and were compared with 221 non-diabetic postmenopausal women, matched by age and body mass index [BMI]. Bone mineral density [BMD] was measured at the L2-L4 vertebrae [anteroposterior projection] and femoral neck with dual energy X-ray absorptiometry [DXA]. The statistical significance was set at a P value of .05 or lower. Prevalence of femoral neck osteoporosis in diabetic women was 30.2 percent [73 cases] and osteopenia was 48.3 percent [117 cases]. Osteoporosis prevalence in spine was 7.9 percent [19 cases] and ostropenia was 46.3 percent [112 cases]. Osteoporosis in both femoral neck [P=0.001] and spine [P=0.04] were significantly higher in patients than in controls. Correlation between HbA1c and femoral neck [p=0.11, correlation coefficient=0.04] and also spine [p=0.10, correlation coefficient= -0.12] T score was not significant. No significant correlation was found between osteoporosis with presence of microalbuminuria [P=0.91], retinopathy [P=0.33], hypertension [P=0.70], ischemic heart disease [P=0.57] and insulin therapy [P=0.08]. This study shows that type 2 diabetic patients have significantly lower T score values and more frequency of osteoporosis than healthy postmenopausal women