STUDY TO ESTABLISH CORRELATION BETWEEN VITAMIN D, PTH AND BMD IN TYPE 2 DIABETIC PATIENTS

Abstract

BACKGROUNDType 2 Diabetes Mellitus still remains one of the leading causes of morbidity and mortality. Diabetic patients are prone to osteoporosis. The development of osteoporosis in diabetes is also promoted by the coexistence of chronic microvascular complications of diabetes, which also affect the bone marrow blood vessels. Diabetic osteopathy is a significant comorbidity of diabetes and is characterised by microarchitectural changes that decrease bone quality and reduction of bone strength leading to an increased risk of bone fracture in diabetes. There is high prevalence of vitamin D deficiency and hyperparathyroidism in uncontrolled diabetic patients, which further leads to osteopenia or osteoporosis.Aims and Objectives- To establish correlation between vitamin D, PTH and BMD with diabetic control and complications of type 2 diabetic patients.MATERIALS AND METHODSAn observational study was conducted in Medicine Department of Nehru Hospital, BRD Medical College, Gorakhpur. Data entry and analysis was done by IBM SPSS Version 22 using Fisher exact test and Pearson Chi-square test. A total of 100 clinically diagnosed patients of type-2 diabetes mellitus were selected for the study. Duration of study was 1 year (Jan 2017 to Dec 2017). All the patients were subjected to detailed clinical history, examination and relevant investigations like HbAlc, BMD, vitamin D, PTH, urine microscopy, fundus etc. were done in all patients.RESULTSThere was high prevalence of abnormal BMD (62%) in T2DM patients. Most of the patients with osteoporosis (30%) had uncontrolled T2DM (86.66%) with low vitamin D (86.66%) and raised PTH (66.67%), while in osteopenic (32%) patients 67.66% had uncontrolled diabetes, 68.75% had low vitamin D and 37.50% had raised PTH (p value= 0.002). In type 2 diabetic patients, vitamin D deficiency was present in 60% patients and hyperparathyroidism in 34% patients.CONCLUSIONPatients with uncontrolled diabetes had high prevalence of microvascular complications. The microvascular complications cause decreased mineralisation of bone and increased risk of abnormal BMD via various metabolic alterations. In poorly controlled diabetic patients, there is increased prevalence of raised PTH and low vitamin D levels which causes osteoporosis and further worsens blood sugar control. Patients with osteoporosis had poor blood sugar control and more prevalence of microvascular complications, which further leads to osteoporosis via vicious cycle. PU - JOURNAL EVOLUTION MEDICAL & DENTAL SCIENCES PI - KARNATAKA PA - C/O AKSHANTALA ENTERPRISES, NO 65, 1ST FL, SAHUKAR CHENNIAH RD, MYSORE, KARNATAKA, 570 009, INDIA