Osteoporosis in older adults with non-insulin-dependent diabetes mellitus: is it sex related?

OBJECTIVE To assess the association of non-insulin-dependent diabetes mellitus (NIDDM) with bone mineral density (BMD) and its effect on bone turnover. METHODS BMD (measured by osteo C.T. of the lumbar spine) and bone resorption (deoxypyridinoline) and formation (alkaline phosphatase bone isoenzyme) markers were measured in 40 female postmenopausal patients with NIDDM and in 40 non-diabetic females of the same age. The same investigations were carried out in 20 males with NIDDM and in 20 normal non-diabetic males. RESULTS Women with diabetes had significantly (p < 0.01) higher BMD levels than women with normal glucose tolerance. Diabetic females were also significantly overweight (p < 0.001) and had a longer duration after menopause (p < 0.02). Bone resorption markers and bone formation markers were significantly (p < 0.001) higher in the control group compared with the diabetic group. Men with diabetes had BMD levels similar to those men with normal glucose tolerance. Also there was no significant difference on comparing bone resorption and formation markers in the group of diabetic men to the control male group. CONCLUSION Older women with NIDDM had better BMD than normal women. No difference in bone density by diabetic status were observed in men. That sex difference may be explained by the obesity and the greater androgenecity reported in women with hyperglycemic and hyperinsulinemic conditions.