Integrating Radiology and Metabolic Risk: DEXA-Based Characterization of Bone Health in Type 2 Diabetes

Area of Science:

• Endocrinology
• Orthopedics
• Geriatrics

Background:

• Type 2 diabetes mellitus (T2DM) is linked to skeletal fragility despite normal or high bone mineral density (BMD), known as the "T2DM bone paradox."
• Saudi Arabia has high rates of diabetes and obesity, necessitating research into their skeletal effects.

Purpose of the Study:

• To investigate the influence of metabolic and demographic factors (BMI, age, sex, HbA1c) on BMD in Saudi adults using DEXA screening.
• To explore the relationship between these factors and bone health in a population with high diabetes and obesity prevalence.

Main Methods:

• Retrospective cross-sectional study of 89 Saudi adults (mean age 61.1 years, 82% female) undergoing DEXA.
• Analysis of BMD at lumbar spine, femoral neck, and total hip.
• Correlation and regression analyses to assess associations between age, sex, BMI, HbA1c, and BMD T-scores.

Main Results:

• Osteopenia and osteoporosis prevalence were 43.8% and 23.6%, respectively.
• Higher BMI positively correlated with BMD at all sites (p < 0.05).
• Older age and female sex were negative predictors of BMD at the femoral neck and hip. HbA1c showed a paradoxical positive association with BMD at weight-bearing sites.

Conclusions:

• Increased BMI is associated with better bone mass, while older age and female sex correlate with reduced BMD in Saudi adults.
• The positive HbA1c-BMD association supports the "diabetic bone paradox," highlighting the need to assess metabolic and skeletal factors for fracture risk in the Middle East.