Vol. 3, Issue 3 (2018)
A study of who FRAX score to predict Fracture risk in Indian type 2 diabetics
Author(s): Dr. Himanshu Arora, Dr. Tilak Raj Khurana, Dr. Garima Goyal, Dr. Sandeep Parekh
Abstract: Objectives: The present study was done to evaluate the bone mineral density and calculate the WHO FRAX score in type 2 diabetic patients. Methods: The present study comprised of a total of 120 diagnosed cases of type-2 Diabetes Mellitus (68 males and 52 females), who were evaluated by detailed history, clinical examination, biochemical parameters (including VIT. D levels), and finally screened for Bone mineral density by DEXA SCAN. These cases were then analyzed for the FRAX SCORE available online. Results: The mean age of the study group was 59.15 years and the mean duration of Diabetes Mellitus was 8.55 years. 19.16% and 25% of the cases were smoker and alcoholic respectively. The mean HbA1c of males was 8.36 and that of females was 7.87 while for the overall study group was 8.14, poor glycaemic control (HbA1c≥9.5) was seen in 19.16% of the total cases. Strict glycaemic control (HbA1c<7%) was seen in only 30% of the study population. The mean cholesterol, serum triglycerides serum HDL, serum LDL and serum VLDL were 148.90, 133.14, 41.94, 72.3, 29.34 mg/dl respectively. The mean serum vitamin d level for males was 30.58nmol/L and for females was 29.25nmol/L while for the overall was 30nmol/L. 3% had optimal serum VIT D levels, 68% were having insufficiency while 29% were deficient. The mean BMD was 0.682 gm/cm2 and the mean T score was -1.63. 34(28.33%) cases out of 120 had T score ≥-1(NORMAL BMD) while 58(48.33%) cases had T score between -1 and -2.5(OSTEOPENIA) and 28(23.33%) cases had T score ≤-2.5(OSTEOPOROSIS).When FRAX score was calculated using the Indian calculator, major osteoporotic fracture had a mean value of 5.485 and hip fracture had a mean of 2.01. VIT.D level was having a significant positive correlation with BMD. BMD was having a significant positive correlation with total cholesterol level. Conclusion: Type 2 diabetics are prone to increased fracture risk as measured by the FRAX score. Only 3% of the total cases in the present study had optimal serum VIT D levels and 28% had their BMD in the normal range. Serum vitamin D levels have positive correlation with BMD and hence their maintenance in the normal range is essential. Type 2 Diabetics should also take measures to contain their serum cholesterol levels as higher levels are associated with decreasing BMD.