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Associations between bone mineral density and subclinical peripheral arterial disease in elderly men with type 2 diabetes mellitus

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Abstract

Summary

The association between peripheral arterial disease (PAD) and osteoporosis in elderly men with type 2 diabetes mellitus (T2DM) remains unclear. We demonstrated the association between subclinical PAD and decreased total hip bone mineral density (BMD) in men aged ≥ 55 years with T2DM, providing clinical clues for the early detection of decreased bone density in total hip.

Purpose

To investigate the association between subclinical peripheral arterial disease (PAD) and bone mineral density (BMD) at total hip, femoral neck, and lumbar spine (L1–4) in elderly men with type 2 diabetes mellitus (T2DM).

Methods

We identified 2,466 patients with confirmed diabetes in this retrospective cross-sectional study. A total of 272 men aged ≥ 55 years with T2DM (50 with subclinical PAD and 222 without PAD) were analyzed. Partial correlation analysis was conducted to explore the associations between ankle-brachial index (ABI) and BMD. Multivariate logistic regression analysis was performed to analyze the contributor for low bone density (T-score <  − 1.0).

Results

Patients with T2DM and subclinical PAD (ABI ≤ 0.9) had significantly lower total hip BMD and T-score (BMD, 0.87 ± 0.14 vs. 0.92 ± 0.15 g/cm2, P = 0.014; T-score, -1.30 [-1.70 to -0.45] vs. -0.80 [-1.40 to 0.00], P = 0.009) than those in the control group. The partial correlation analyses indicated that ABI significantly correlated with the total hip T-score (adjusted r = 0.166, P = 0.009). The logistic regression analysis indicated that subclinical PAD was an independent risk factor for the risk of decreased bone density in total hip (adjusted odds ratio [95% CI]: 8.933 [1.075–74.222], P = 0.043). 

Conclusion

Subclinical PAD (ABI ≤ 0.9) could be used as a risk factor for decreased total hip BMD in men aged ≥ 55 years with T2DM, which provides clinical clues for the early detection of low bone density in total hip in such populations.

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Funding

This study was funded by the Wenzhou Municipal Science and Technology Bureau Foundation (Y20210432).

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Authors and Affiliations

  1. Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China

    X. Zhang, Y. Xu, F. Li & M. Chen

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All authors have met the requirements for authorship. MC had the idea for and designed the study. XZ, YX, FL, and MC collected data and processed statistical analysis. XZ and MC interpreted data and drafted the manuscript. All the authors reviewed and approved the final version of the manuscript.

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Correspondence to M. Chen.

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This study was approved by the Medical Ethics Review Committees of the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University.

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The requirement of informed consent was waived due to the retrospective design of the study.

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Xiumeng Zhang, Yu Xu, Feida Li, and Mochuan Chen declare that they have no conflict of interest.

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Zhang, X., Xu, Y., Li, F. et al. Associations between bone mineral density and subclinical peripheral arterial disease in elderly men with type 2 diabetes mellitus. Osteoporos Int 33, 1715–1724 (2022). https://doi.org/10.1007/s00198-022-06404-z

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