Evaluation of bone mineral density and trabecular bone score for diagnosis of osteoporosis in Iranian diabetic patients

Introduction: Type 2 diabetes mellitus (T2DM) increases the risk of bone fractures. Objectives: This study aimed to examine the use of trabecular bone score (TBS) and BMD to select the best diagnostic tool for osteoporosis caused by type 2 diabetes. Patients and Methods: One hundred and four patients (52 individuals with type 2 diabetes and 52 ones without diabetes) aged at most 50 years were enrolled in a cross-sectional study that was conducted with dual-energy X-ray absorptiometry (DXA) images of patients referred to Khorshid and Al-Zahra hospitals, Isfahan, Iran. Results: Lumbosacral bone mineral density (BMD) was significantly lower in the diabetic group than in the control group (0.76 versus 0.82, P=0.041). The mean lumbosacral TBS was significantly lower in the diabetic group than in the controls (1.24 versus 1.36, P=0.001). Therefore, the lumbosacral TBS provided a more reliable indicator than lumbosacral BMD to discriminate between controls and women with T2DM. Conclusion: The TBS is recommended for early diagnosis of osteoporosis in diabetic patients because of its independence from BMD-related parameters. The TBS can capture a larger portion of the bone deterioration in women with T2DM that cannot be detected using methods based solely on BMD.