title: Increased risk of osteoporosis in postmenopausal women with type 2 diabetes mellitus: a three-year longitudinal study with phalangeal QUS measurements.
abstract: Type 2 diabetes mellitus (T2DM) is associated with a higher risk of fractures even in presence of normal or increased bone mineral density. The purpose of this three-year longitudinal study was to evaluate the risk of osteoporotic fractures by assessing the changes of Quantitative Ultrasound (QUS) parameters in a group of postmenopausal women with type 2 diabetes mellitus (T2DM) compared with non-diabetic controls. The measurements were taken on a group of 18 postmenopausal women affected by T2DM and 18 healthy age-matched controls, aged 55-70 years, referring to the Osteolab laboratory at the ISBEM Research Institute (Brindisi, Italy) between 2009 and 2013. Subjects had baseline and 3-year follow-up measurements with phalangeal QUS carried out by a DBM Sonic Bone Profiler 1200 (Igea®); medical history, current drug therapies and risk factors for fractures were recorded for each patient. The analyzed phalangeal QUS parameters were Amplitude-Dependent Speed of Sound (AD-SoS), Bone Transmission Time (BTT), Fast Wave Amplitude (FWA) and Signal Dynamic (SDy). At the baseline visit we found no statistically significant difference between T2DM and non-diabetic patients when looking at phalangeal QUS parameters. At the three-year follow-up visit, a significantly higher decrease of both BTT (P<0.001) and AD-SoS (P<0.001) parameters was found in the T2DM group. On the contrary, the decrease of FWA was significantly higher in non-diabetic controls (P<0.001). Our data confirm the ability of phalangeal QUS to detect differences in the risk of osteoporotic fractures in T2DM postmenopausal women compared to non-diabetic controls. The study suggests that T2DM women present a higher cortical porosity and increased trabecular bone density compared to non-diabetic controls, respectively shown by the higher decrease of both AD-SoS and BTT and the lower decrease of FWA.
authors.affiliation: Euro Mediterranean Biomedical Scientific Institute, Brindisi, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Neglia
authors.affiliation: Euro Mediterranean Biomedical Scientific Institute, Brindisi, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Agnello
authors.affiliation: Euro Mediterranean Biomedical Scientific Institute, Brindisi, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Argentiero
authors.affiliation: Euro Mediterranean Biomedical Scientific Institute, Brindisi, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Chitano
authors.affiliation: Euro Mediterranean Biomedical Scientific Institute, Brindisi, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Quarta
authors.affiliation: Euro Mediterranean Biomedical Scientific Institute, Brindisi, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Bortone
authors.affiliation: Euro Mediterranean Biomedical Scientific Institute, Brindisi, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Della Rosa
authors.affiliation: Department of Endocrinology, Local Health Authority, ASL Brindisi, Brindisi, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Caretto
authors.affiliation: Euro Mediterranean Biomedical Scientific Institute, Brindisi, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Distante
authors.affiliation: Division of Endocrinology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Colao
authors.affiliation: IRCCS SDN Foundation, Naples, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Di Somma
authors.affiliation: Department of Rheumatology, Fatebenefratelli St. Peters Hospital, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Migliore
authors.affiliation: Division of Epidemiology, IOS, Southern Italy Hospital Institute, Naples, Italy.
authors.forename: R S
authors.initials: RS
authors.lastname: Auriemma
authors.affiliation: Division of Epidemiology, IOS, Southern Italy Hospital Institute, Naples, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Piscitelli
mesh_terms: D000368:Aged; D015992:Body Mass Index; D015519:Bone Density; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D050278:Finger Phalanges / Q000000981:diagnostic imaging*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000209:etiology*; D012306:Risk; D014463:Ultrasonography