title: The relationship between insulin resistance and osteoporosis in elderly male type 2 diabetes mellitus and diabetic nephropathy.
abstract: OBJECTIVE
  Diabetes is often associated with complications and comorbidities. Diabetic osteoporosis (OP) is increasingly recognized as a significant comorbidity of type 2 diabetes mellitus (T2-DM). In this study, we intended to determine whether type 2 diabetes was associated with a higher bone mineral density (BMD) in older males, and investigate the related risk factors of diabetes mellitus accompanied with OP.
  
  
  METHODS
  To assess the effects of diabetes and its complications on the risk of bone fractures, the daily glycemia, insulin and HbAlc of T2-DM patients were detected. At the same time, Dual Energy X-ray Absorptiometry (DEXA) was used to measure the BMD of whole body, lumbar spine and proximal femoral at 2-year intervals.
  
  
  RESULTS
  The BMD in elderly male patients suffered from T2-DM was associated with kidney function. The decrease of BMD in elderly male patients with T2-DM was related to HbA1c and body mass index (BMI). The BMD in group of renal function insufficiency or clinical albuminuria which are closely related with insulin insufficiency were much lower than that in the group of normal control. Additionally, a significantly lower (P<0.05) T-score was found in patients with nephropathy as compared with those without the complications.
  
  
  CONCLUSIONS
  The elderly patients with type 2 diabetes mellitus are prone to develop OP. The insufficiency of insulin, the decreased insulin sensitivity and diabetic nephropathy are important causes for OP in the patients with type 2 diabetes.
authors.affiliation: Department of Geratology, Shanghai JiaoTong University, Affiliated Sixth People's Hospital, Shanghai 200233, China.
authors.forename: Jinwei
authors.initials: J
authors.lastname: Xia
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhong
authors.forename: Gaozhong
authors.initials: G
authors.lastname: Huang
authors.forename: Yajuan
authors.initials: Y
authors.lastname: Chen
authors.forename: Huipen
authors.initials: H
authors.lastname: Shi
authors.forename: Zhenlin
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism / Q000652:urine; D003928:Diabetic Nephropathies / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism / Q000652:urine; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology* / Q000209:etiology / Q000378:metabolism / Q000652:urine; D012307:Risk Factors