Low bone mineral density and fracture burden in postmenopausal women

Ann Cranney; Sophie A. Jamal; James F. Tsang; Robert G. Josse; William D. Leslie

doi:10.1503/cmaj.070234

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Diabetes and osteoporotic fractures.
Luca Mascitelli

Posted on: 25 September 2007

Posted on: (25 September 2007)
Page navigation anchor for Diabetes and osteoporotic fractures.
Diabetes and osteoporotic fractures.
Luca Mascitelli
Cranney and colleagues (1) found that, in the studied population of postmenopausal women, most fracture occurred in women with normal or osteopenic bone mineral density. Therefore, they suggested that other factors than bone mineral density may influence bone strenght or the risk of falls thus contributing to fracture risk (1). However, among these risk factors, they did not mention type 2 diabetes. Mounting evidence sugg...
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Cranney and colleagues (1) found that, in the studied population of postmenopausal women, most fracture occurred in women with normal or osteopenic bone mineral density. Therefore, they suggested that other factors than bone mineral density may influence bone strenght or the risk of falls thus contributing to fracture risk (1). However, among these risk factors, they did not mention type 2 diabetes. Mounting evidence suggests that patients with type 2 diabetes may have an increased risk of certain types of osteoporotic fractures despite a higher bone mineral density (2,3). Of note, the presence of diabetes in patients with a hip fracture has been shown to represent a risk factor for increased mortality (4). Furthermore, the incresing number of diabetic patients on thiazolidediones therapy might also contribute to this higher fracture risk. (5) Thus, type 2 diabetes should be considered as an important clinical risk factor into the the calculation of future fracture risk.
Luca Mascitelli, MD Sanitary Service Comando Brigata alpina “Julia” Udine, Italy 33100
Francesca Pezzetta, MD Cardiology Service Ospedale di San Vito al Tagliamento San Vito al Tagliamento, Italy 33078
REFERENCES
1. Cranney A, Jamal SA, Tsang JF, Josse RG, Leslie WD. Low bone mineral density and fracture burden in postmenopausal women. CMAJ 2007;177:575-80.
2. Schwartz AV, Sellmeyer DE, Ensrud KE, et al. Older women with diabetes have an increased risk of fracture: a prospective study. J Clin Endocrinol Metabol. 2001;86:32–8.
3. Strotmeyer ES, Cauley JA, Schwartz AV, et al. Nontraumatic fracture risk with diabetes mellitus and impaired fasting glucose in older white and black adults. Arch Intern Med2005;165:1612-7.
4. Meyer HE, Tverdal A, Falch JA, Pedersen JI. Factors associated with mortality after hip fracture. Osteoporos Int 2000;11:228-32.
5. Mascitelli L. Pezzetta F, Songini M. Detrimental action of thiazolidinediones on bone. Eur J Intern Med 2007;18:447.
Conflict of Interest:
None declared
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Competing Interests: None declared.