Impact of Type 2 Diabetes Mellitus and Chronic Kidney Disease on Bone Mineral Density in Elderly Patients With Fragility Hip Fracture: A Cross-Sectional Study

Objectives

Diabetes mellitus (DM) and chronic kidney disease (CKD) are prevalent conditions in the elderly population, increasing the risk of bone fractures due to their adverse effects on bone quality. This study aimed to assess their impact on bone health and propose interventions to mitigate fracture risk in this demographic.

Methods

A cross-sectional study involving 571 elderly patients (aged ≥ 65 years) with fragility hip fractures was conducted at a tertiary care hospital between June 2014 and June 2016. Patients were categorized into four groups based on DM and CKD presence. Bone mineral density (BMD) at the femoral neck was measured using dual-energy X-ray absorptiometry (DXA) scan. Statistical analysis included ANOVA with Bonferroni correction.

Results

The mean age was 79.5 ± 7.3 years, with females comprising 70.6%. Group 2 (No CKD with diabetes) exhibited higher T-scores than Group 1 (No CKD or Diabetes). Patients with DM had higher T-scores, with an increase of 0.2 compared to those without DM and CKD. Surprisingly, CKD and DM coexistence (Group 4) did not worsen T-scores. Higher HbA1c levels were positively associated with a higher T-score, but this was lost in concurrent CKD.

Conclusions

Patients with DM had higher T-scores; the combination of CKD and DM did not worsen T-scores. However, the positive association between higher HbA1c and higher T-score was nullified in concurrent CKD. These findings emphasize the need for tailored interventions to mitigate fracture risk in elderly populations with DM and CKD.