BONE MASS IN NON-INSULIN-DEPENDENT DIABETES-MELLITUS

In view of the contradictory results of earlier reports regarding bone mass in patients with non-insulin-dependent diabetes, we measured bon e mass using dual X-ray absorptiometry and ultrasound measurements of the right calcaneus in 36 type 2 diabetic subjects, i.e. 21 men and 15 postmenopausal women aged 40-65 years, and compared their bone mass t o a sex- and age-matched control group. We also measured several metab olic parameters in the diabetic population and studied the relationshi p between these metabolic parameters and the bone parameters using cor relation analysis. We found a tendency to higher bone mass in the diab etic subjects compared to the normal controls. In the Type 2 diabetic postmenopausal women, fat mass and lean body mass correlated positivel y with total body bone mineral density (BMD) (r = 0.53 and 0.68), and with total body bone mineral content (BMC) (r = 0.58 and 0.77). Insuli n sensitivity (GDR/I) correlated negatively with total body BMC and BM D(r = -0.68 and -0.61). Serum insulin correlated positively with the s ame bone parameters. When controlling for fat mass or lean body mass u sing a multiple regression analysis, the correlation between insulin s ensitivity and BMD became non-significant. This suggests that body mas s is a more important determinant of BMD than hyperinsulinaemia or ins ulin resistance in diabetic women. Among the diabetic men there was a significant positive correlation between lean body mass and BMC (r = 0 .66), between serum oestrone and BMD (r = 0.49) and between serum insu lin and femoral neck BMD (r = 0.53). Apart from this there were no sig nificant correlations between the individual hormones, insulin sensiti vity, total body fat percentage, fat mass, weight, BMI and the bone pa rameters.