title: Severity and pattern of bone mineral loss in endocrine causes of osteoporosis as compared to age-related bone mineral loss.
abstract: BACKGROUND
  Data are scant on bone health in endocrinopathies from India. This study evaluated bone mineral density (BMD) loss in endocrinopathies [Graves' disease (GD), type 1 diabetes mellitus (T1DM), hypogonadotrophic hypogonadism (HypoH), hypergonadotropic hypogonadism (HyperH), hypopituitarism, primary hyperparathyroidism (PHPT)] as compared to age-related BMD loss [postmenopausal osteoporosis (PMO), andropause].
  
  
  METHODS
  Retrospective audit of records of patients >30 years age attending a bone clinic from August 2014 to January 2016 was done.
  
  
  RESULTS
  Five-hundred and seven records were screened, out of which 420 (females:male = 294:126) were analyzed. A significantly higher occurrence of vitamin D deficiency and insufficiency was noted in T1DM (89.09%), HyperH (85%), and HypoH (79.59%) compared to age-related BMD loss (60.02%; P < 0.001). The occurrence of osteoporosis among females and males was 55.41% and 53.97%, respectively, and of osteopenia among females and males was 28.91% and 32.54%, respectively. In females, osteoporosis was significantly higher in T1DM (92%), HyperH (85%), and HypoH (59.26%) compared to PMO (49.34%; P < 0.001). Z score at LS, TF, NOF, and greater trochanter (GT) was consistently lowest in T1DM women. Among men, osteoporosis was significantly higher in T1DM (76.67%) and HypoH (54.55%) compared to andropause (45.45%; P = 0.001). Z score at LS, TF, NOF, GT, and TR was consistently lowest in T1DM men. In GD, the burden of osteoporosis was similar to PMO and andropause. BMD difference among the study groups was not significantly different after adjusting for body mass index (BMI) and vitamin D.
  
  
  CONCLUSIONS
  Low bone mass is extremely common in endocrinopathies, warranting routine screening and intervention. Concomitant vitamin D deficiency compounds the problem. Calcium and vitamin D supplementations may improve bone health in this setting.
authors.affiliation: Department of Endocrinology, Post-graduate Institute of Medical Education and Research (PGIMER) and Dr. Ram Manohar Lohia (RML) Hospital, New Delhi, India.
authors.forename: D
authors.initials: D
authors.lastname: Dutta
authors.affiliation: Department of Endocrinology, Post-graduate Institute of Medical Education and Research (PGIMER) and Dr. Ram Manohar Lohia (RML) Hospital, New Delhi, India.
authors.forename: P
authors.initials: P
authors.lastname: Dharmshaktu
authors.affiliation: Department of Endocrinology, Post-graduate Institute of Medical Education and Research (PGIMER) and Dr. Ram Manohar Lohia (RML) Hospital, New Delhi, India.
authors.forename: A
authors.initials: A
authors.lastname: Aggarwal
authors.affiliation: Department of Endocrinology, Post-graduate Institute of Medical Education and Research (PGIMER) and Dr. Ram Manohar Lohia (RML) Hospital, New Delhi, India.
authors.forename: K
authors.initials: K
authors.lastname: Gaurav
authors.affiliation: Department of Endocrinology, Post-graduate Institute of Medical Education and Research (PGIMER) and Dr. Ram Manohar Lohia (RML) Hospital, New Delhi, India.
authors.forename: R
authors.initials: R
authors.lastname: Bansal
authors.affiliation: Department of Endocrinology, Post-graduate Institute of Medical Education and Research (PGIMER) and Dr. Ram Manohar Lohia (RML) Hospital, New Delhi, India.
authors.forename: N
authors.initials: N
authors.lastname: Devru
authors.affiliation: Department of Radiology, Post-graduate Institute of Medical Education and Research (PGIMER) and Dr. Ram Manohar Lohia (RML) Hospital, New Delhi, India.
authors.forename: U C
authors.initials: UC
authors.lastname: Garga
authors.affiliation: Department of Endocrinology, Post-graduate Institute of Medical Education and Research (PGIMER) and Dr. Ram Manohar Lohia (RML) Hospital, New Delhi, India.
authors.forename: B
authors.initials: B
authors.lastname: Kulshreshtha
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging; D047649:Andropause; D015519:Bone Density; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005260:Female; D006111:Graves Disease / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism; D010384:Pelvic Bones / Q000378:metabolism / Q000503:physiopathology; D017698:Postmenopause; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014808:Vitamin D Deficiency / Q000150:complications* / Q000453:epidemiology