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This version published online on March 4, 2008
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2007-1760
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Submitted on August 6, 2007
Accepted on February 26, 2008

Differences between Measurements of Bone Mineral Densities by Quantitative Ultrasound and Dual Energy X-ray Absorptiometry in Type 2 Diabetic Postmenopausal Women

Bei Tao, Jian-Min Liu, Hong-Yan Zhao, Li-Hao Sun, Wei-Qing Wang, Xiao-Ying Li, and Guang Ning*

Department of Endocrine and Metabolic Diseases, Rui-jin Hospital, Shanghai Jiao-tong University School of Medicine; Shanghai, 200025, China; Shanghai Clinical Center for Endocrine and Metabolic Diseases; Shanghai Institute of Endocrinology and Metabolism, Endocrine and Metabolic Division,E-Institutes of Shanghai Universities(EISU)

* To whom correspondence should be addressed. E-mail: guangning{at}medmail.com.cn.

Context: Quantitative ultrasound (QUS) may be more helpful than dual energy X-ray absorptiometry (DXA) in detecting bone deficits in patients with type 2 diabetes mellitus (T2DM).

Objective: To compare differences in bone mass measurement by DXA and QUS in T2DM and nondiabetic postmenopausal women.

Design, Setting and Participants: This clinical investigation was a cross-sectional study in 76 patients with T2DM and 86 nondiabetic postmenopausal women.

Main Outcome Measures: The primary outcomes were speed of sound (SOS) at the radius, phalanx and tibia measured by QUS, and bone mineral density (BMD) at the lumbar spine (LS), femoral neck (FN) and total hip (TH) measured by DXA.

Results: BMDs in T2DM patients were higher (LS, 1.06 ± 0.12 vs. 0.90 ± 0.23 g/cm2; FN, 0.80 ± 0.13 vs. 0.74 ± 0.12 g/cm2; TH, 0.87 ± 0.14 vs. 0.80 ± 0.13 g/cm2, respectively P < 0.001), while SOSs were lower than those in nondiabetics (radius, 4044 ± 178 vs. 4129 ± 182 m/s; phalanx, 3902 ± 207 vs. 3999 ± 214 m/s, respectively P < 0.001). The positive relationships between SOS and BMD (r = 0.26–0.75, P <0.05) in nondiabetics were not observed in women with T2DM. T2DM impacted negatively on SOSs (radial, ß= -0.223, P <0.01; phalanx, ß= -0.219, P <0.01), but positively on BMDs (LS, ß= 0.314, P <0.001; FN, ß= 0.173, P <0.05; TH, ß= 0.203, P <0.01).

Conclusions: Differences in bone mass as measured by DXA and QUS in postmenopausal T2DM and nondiabetic women do not change in parallel. QUS can provide useful information in the skeletal assessment of patients with T2DM.
Key words: type 2 diabetes • bone mineral density • DXA • quantitative ultrasound






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