INDEPENDENT AND COMBINED EFFECTS OF HYPERGLYCEMIA AND CHRONIC KIDNEY DISEASE ON BONE MINERAL DENSITY AND
I C Mogos1,2, D A Niculescu1,3, R Dusceac4
1"Carol Davila" University of Medicine and Pharmacy - Endocrinology.
Acta Endocrinologica (Bucharest, Romania : 2005)
|March 9, 2026
Summary
Abnormal glucose metabolism and chronic kidney disease (CKD) independently affect bone mineral density (BMD). Intensive management of these conditions may prevent bone loss and architectural damage in patients with coexisting prediabetes or type 2 diabetes mellitus (T2DM).
Area of Science:
- Endocrinology
- Nephrology
- Bone Metabolism
Background:
- Abnormal glucose metabolism (prediabetes, type 2 diabetes mellitus [T2DM]) and chronic kidney disease (CKD) frequently coexist.
- Both conditions significantly impact bone mass and microarchitecture.
- Understanding their independent and combined effects on bone health is crucial.
Purpose of the Study:
- To investigate the independent and combined effects of abnormal glucose metabolism and CKD on bone mineral density (BMD) and microarchitecture.
- To assess how these conditions influence bone health in a cohort of patients with prediabetes or T2DM.
Main Methods:
- An observational, single-center, prospective study included 604 participants with prediabetes/T2DM or normal glucose tolerance (NGT), with or without CKD.
- Lumbar spine, femoral neck, and 33% radius BMD, along with trabecular bone score (TBS), were measured.
- Vitamin D levels and glycemic control (HbA1c) were assessed.
Main Results:
- Patients with prediabetes/T2DM had significantly higher BMD at all measured sites compared to NGT patients.
- CKD did not significantly alter BMD or TBS, irrespective of glycemic status, even in older individuals.
- No association was found between HbA1c levels and BMD or TBS.
Conclusions:
- Impaired glucose metabolism and CKD exert independent, but not additive, effects on BMD and microarchitecture.
- Well-controlled diabetes and sufficient vitamin D levels are key factors.
- Independent, intensive management and screening for both conditions are recommended to prevent bone loss and architectural damage.
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