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Background <p>Type 2 diabetes mellitus (T2DM) is associated with alterations in bone metabolism, bone strength, and quality. There is limited literature available regarding the effect of diabetes mellitus (DM) on chronic kidney disease-mineral and bone disorder (CKD-MBD). The study aimed to compare bone mineral health in pre-dialysis CKD patients with and without DM.</p> Materials and methods <p>This cross-sectional study included patients with CKD G3-5 (age ≥ 40 years) categorized into CKD-DM or CKD-non-DM(CKD-NDM) groups. Bone mineral density (BMD), trabecular bone score (TBS), and hip structural analysis (HSA) were assessed using dual-energy X-ray absorptiometry (DXA). Vertebral fractures (VFs) were assessed by lateral dorsolumbar spine radiography.</p> Results <p>Of 306 CKD patients (<i>n</i> = 153 per group) age was comparable (57.42 <b>±</b> 9.6 vs. 56.1 <b>±</b> 9.2 years; <i>p</i> = 0.23), CKD-DM patients had higher body mass index, waist circumference and estimated glomerular filtration rate. After adjusting for confounders, there was no difference in the prevalence of osteoporosis between CKD-DM and CKD-NDM groups (22.9% vs. 34%, <i>p</i> = 0.208). However, the prevalence of osteoporosis at distal forearm (FA) was higher in CKD-NDM (34.9% vs. 50.7%, <i>p</i> = 0.024). The mean TBS (1.341 ± 0.113 vs. 1.358 ± 0.142; <i>p</i> = 0.722) and prevalence of abnormal TBS were similar, though CKD-NDM had higher proportion of patients with degraded TBS(≤1.23) (11.8% vs. 20.3%, <i>p</i> = 0.007). In CKD-NDM, the buckling ratio at femoral shaft was significantly higher and neck-shaft angle was wider. Morphometric VFs were comparable between groups.</p> Conclusion <p>In this cohort of patients with pre-dialysis CKD, the prevalence of osteoporosis, abnormal TBS and morphometric VFs were similar between subjects with and without DM. However, CKD-NDM group demonstrated higher rates of forearm osteoporosis and degraded TBS, as well as high risk HSA parameters.</p>

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Does bone health differ between patients of chronic kidney disease with and without type 2 diabetes mellitus? - A comparative cross-sectional study

  • 期刊论文

  • 发表日期：

    2026年5月2日

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  • Varun Suryadevara,
  • Anitha Sebastian,
  • Rashmi K. G,
  • Aravind Prasad,
  • Deepika Patel,
  • G Ramkumar,
  • Priyamvada PS,
  • R Anusuya,
  • Jayaprakash Sahoo,
  • Sadishkumar Kamalanathan,
  • Vijaya Bhaskar Reddy,
  • Dukhabandhu Naik

摘要

Background

Type 2 diabetes mellitus (T2DM) is associated with alterations in bone metabolism, bone strength, and quality. There is limited literature available regarding the effect of diabetes mellitus (DM) on chronic kidney disease-mineral and bone disorder (CKD-MBD). The study aimed to compare bone mineral health in pre-dialysis CKD patients with and without DM.

Materials and methods

This cross-sectional study included patients with CKD G3-5 (age ≥ 40 years) categorized into CKD-DM or CKD-non-DM(CKD-NDM) groups. Bone mineral density (BMD), trabecular bone score (TBS), and hip structural analysis (HSA) were assessed using dual-energy X-ray absorptiometry (DXA). Vertebral fractures (VFs) were assessed by lateral dorsolumbar spine radiography.

Results

Of 306 CKD patients (n = 153 per group) age was comparable (57.42 ± 9.6 vs. 56.1 ± 9.2 years; p = 0.23), CKD-DM patients had higher body mass index, waist circumference and estimated glomerular filtration rate. After adjusting for confounders, there was no difference in the prevalence of osteoporosis between CKD-DM and CKD-NDM groups (22.9% vs. 34%, p = 0.208). However, the prevalence of osteoporosis at distal forearm (FA) was higher in CKD-NDM (34.9% vs. 50.7%, p = 0.024). The mean TBS (1.341 ± 0.113 vs. 1.358 ± 0.142; p = 0.722) and prevalence of abnormal TBS were similar, though CKD-NDM had higher proportion of patients with degraded TBS(≤1.23) (11.8% vs. 20.3%, p = 0.007). In CKD-NDM, the buckling ratio at femoral shaft was significantly higher and neck-shaft angle was wider. Morphometric VFs were comparable between groups.

Conclusion

In this cohort of patients with pre-dialysis CKD, the prevalence of osteoporosis, abnormal TBS and morphometric VFs were similar between subjects with and without DM. However, CKD-NDM group demonstrated higher rates of forearm osteoporosis and degraded TBS, as well as high risk HSA parameters.