Factors associated with bone mineral density and risk of fall in korean adults with type 2 diabetes mellitus aged 50 years and older

Context: Osteoporotic fractures in subjects with diabetes mellitus (DM) carry higher mortality and morbidity. Because bone strength and minor trauma, such as a falls, are considered to be significant factors contributing to osteoporotic fractures, it is important to elucidate the associated factors with these.

Objective: This studywasperformed to investigate the factors associated withbonemineral density (BMD) and falls in noninstitutionalized subjects with DM aged 50 years or older.

Design, Setting, and Patients: We used the database from the 2010 Fifth Korea National Health and Nutrition Examination Survey. Subjects withDMaged 50 years or older were selected and included in the data analyses. Associated factors with BMD of the femoral neck and lumbar spine and those with fallswereanalyzedusingmultiple linear regressionandbinary logistic regression analyses, respectively.

Results: Three hundred sixty-two subjects [209 males; 153 females; average age, 66.0 y (SD 8.2 y)] were included. Amongthe male subjects, the total body muscle mass (P<.001), daily calcium intake (P= .001), ALP levels (P= .007), and body mass index (P= .027) were significantly associated with femoral neck BMD, whereas body mass index (P= .001) and ALP levels (P= .040) were associated with lumbar spine BMD. Among the female subjects, age (P<.001), daily calcium intake (P=.011) andtotalbodymuscle mass (P=.023)werefoundtobesignificantly associated factors with femoral neck BMD, whereas age (P< .001) and body mass index (P= .012) and daily calcium intake (P= .040) were those with lumbar spine BMD. Osteoarthritis (P= .024) and total body muscle mass (P= .028) were found to be significantly associated with the risk of falls.

Conclusions: Total body muscle mass was the most prominent factor predicting femoral neck BMD and risk of falls in community-dwelling elderly subjects with DM. Further investigation is required to determine their role in preventing osteoporotic fractures in diabetic subjects.