| [ Summary ] |
Bone disease in hemodialysis (HD) patients with type 2 diabetes mellitus (DM) is characterized by low bone turnover, resulting from either impaired secretion of parathyroid hormone or osteoblast dysfunction. It has recently been hypothesized that low bone turnover disease may cause a deterioration in bone quality. The prevalence rate of vertebral fractures in type 2 DM HD patients was 32.3 %, which was greater than that of non-DM HD patients (13.3 %) when adjusted for age and HD duration. Logistic regression analysis elucidated the presence of DM and age as independent risk factors for the increased prevalence of vertebral fractures in HD patients. In non-DM HD patients, those with vertebral fractures were significantly older BMD in either lumbar spine or distal radius 1/3 significantly lower than the respective value in those without fractures. However, in DM HD patients, neither BMD in the lumbar spine nor distal radius 1/3 was significantly lower in those with vertebral fractures than in those without. Furthermore, age did not differ significantly between DM HD patients with and without fractures.
In conclusion, low bone turnover disease in type 2 DM HD patients might be responsible for a significantly higher incidence of vertebral fractures than in non-DM HD patients, independent of bone mass. |