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Relationship between diabetes and bone health status in adults with diabetes

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Title: Relationship between diabetes and bone health status in adults with diabetes
Author(s): Naseri Kouzehgarani, Ghazal
Advisor(s): Chapman-Novakofski, Karen M.
Department / Program: Nutritional Sciences
Discipline: Nutritional Sciences
Degree Granting Institution: University of Illinois at Urbana-Champaign
Degree: M.S.
Genre: Masters
Subject(s): Diabetes Osteoporosis Bone Mass Density Heel Ultrasound Gene Marker Vitamin D Receptor
Abstract: Studies of bone density and diabetes have relatively strong evidence to suggest that type 1 diabetes has negative impacts on bone mass density; however, there seems to be more discrepancy in skeletal effects of type 2 diabetes. While many studies have shown normal to high BMD values in individuals with type 2 diabetes, some have found low BMD values. We studied the relationship between diabetes-related variables and bone health status, specifically osteoporosis, by examining heel ultrasound and genetic markers. The objective of this study was to compare the bone mass density (BMD) and vitamin D receptor (VDR) gene marker of adult men and women with pre-, type 1 and type 2 diabetes (n=54). Subjects were recruited from faculty, staff and students of the University of Illinois at Urbana-Champaign, as well as participants from the Senior High Rise DM Outreach groups from Champaign-Urbana Public Health Department. Anthropometric measurements including height, weight, wrist, waist and hip circumferences were taken. Participants completed a self-administered questionnaire on demographics, diabetes status, lifestyles and health behaviors, physical activity, history of falling and bone fracture, current status and/or history of medical conditions and medication use, family history of diabetes and bone health-related diseases, and female reproductive history. Heel ultrasound (Hologic Sahara) was measured for bone analysis (n=52). Saliva samples were collected for DNA genotyping (n=50) and only analyzed for the VDR gene marker of Caucasian/white ethnic group (n=45). Among the 54 subjects, mean age was 62 years (27-86 years) and median for duration of diabetes was 7 years (0.08-50 years). The majority of participants were white/Caucasian women with college/professional degree, who had type 2 diabetes, were not on insulin and had diabetes for 7 or more years. Bone mineral density was lower in subjects with type 1 diabetes compared to those with type 2 diabetes, but this difference lacked statistical significance. However, adjusting for age resulted in lower BMD and T-score values in individuals with type 1 diabetes as well as higher T-scores in those with type 2 diabetes. Odds ratio of high BMD values were about 14.5 times greater in subjects with type 2 diabetes than those with type 1 diabetes, which increased after adjustment for BMI. Univariate analysis detected significant associations for low bone mass density with age, current status and/or history of cancer, current use and/or history of any type of bone medication intake, menopause in females, and moderate physical activity in the past 7 days. Multiple regression model showed that African-American ethnicity, calcium/vitamin D supplement use, family history of loss of height, current status and/or history of osteoporosis, and menopause in females were significant predictors of low bone mass density. No statistically significant association was found between VDR genotype and bone mass density. Only age, duration of diabetes and menopause were significant independent risk factors for low BMD, but VDR genotype or VDR polymorphism were not associated with an increased risk for low BMD. In conclusion, additional research is needed to understand the link between BMD, diabetes status and VDR genetic marker.
Issue Date: 2012-02-01
Genre: thesis
URI: http://hdl.handle.net/2142/29539
Rights Information: Copyright 2011 Ghazal Naseri Kouzehgarani
Date Available in IDEALS: 2014-02-01
Date Deposited: 2011-12
 

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