Correlation of bone mineral density with peripheral neuropathy in patients with insulin dependent diabetes mellitus

ABSTRACT

To investigate whether peripheral neuropathy [PN], as part of the microangiopathic complex, can affect bone mineral density [BMD] of the axial skeleton in patients with type 1 diabetes. Three studied groups where examined. Group 1 comprised 15 males with type 1 diabetes and severe PN with a mean duration of diabetes of 11.07 +/- 2.31 years and an HbA1c% of 9.40+ 1.01.Group2 comprised 15 males type 1 diabetic patients with absent or mild PN matched to patients of group 1 regarding age, weight, and duration of diabetes. Group3 comprised 15 control subjects. BMD was measured by dual energy x-ray absorptiometry [DEXA] of the axial skeleton. In group 1, BMD was significantly reduced in the axial skeleton compared with an expected Z score of 0 [spine, -1.26 +/- 0.52]. To a lesser exlent, but still significantly, group 2 also showed reduced BMD values [spine, -0.54 +/- 0.16],whereas group 3 had normal BMD values [spine, -0.19 +/- 0.23]. Group 1 had lower mean BMD level than group 2 and group 3 at the measured sites which was statistically significant [analysis of variance, P< 0.001]. No significant differences in physical activity levels or serum calcium, serum phosphorus, alkaline phosphatase, were demonstrated between the two patient groups. The present results suggest that in patients with type 1 diabetes PN may be an independent risk factor for reduced BMD in the axial skeleton