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Summary <p>We assessed bone health in over 2500 adults with diabetes across Türkiye. T1DM patients had lower BMD, while T2DM patients showed higher fracture risk despite higher BMD. Several modifiable factors were linked to osteoporosis. These findings support personalized bone assessments in diabetic populations.</p> Background <p>Diabetes mellitus (DM) is a recognized risk factor for bone fragility. While type 1 DM (T1DM) is typically associated with low bone mineral density (BMD), type 2 DM (T2DM) often presents with higher BMD despite increased fracture risk. Large-scale comparative studies remain limited.</p> Objective <p>To evaluate bone health, including osteopenia, osteoporosis, and fracture risk, in adults with T1DM and T2DM.</p> Methods <p>This multicenter, cross-sectional study included 2562 patients (224 with T1DM, 2338 with T2DM) from 27 centers across Türkiye. BMD was assessed using dual-energy X-ray absorptiometry (DXA) and fracture risk was estimated via the Turkish-adapted FRAX® algorithm in patients aged ≥ 40&#xa0;years. Multinomial logistic regression was used to identify independent predictors of low BMD.</p> Results <p>Osteoporosis prevalence was 5.5% in T1DM and 9.6% in T2DM (femoral neck T-score). Adjusted BMD was significantly lower in T1DM at all skeletal sites, while FRAX-based fracture risk and fall-related fractures were higher in T2DM. Independent predictors of osteoporosis included older age, female sex, lower BMI, reduced calcium levels, corticosteroid use, albuminuria, hypertension, and less frequent sodium-glucose cotransporter-2 (SGLT2) inhibitor use. T1DM was independently associated with osteopenia but not osteoporosis.</p> Conclusion <p>This multicenter study demonstrates distinct patterns of BMD and fracture risk across diabetes subtypes and supports individualized bone health assessment in routine diabetes care.</p>

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Bone health and fracture risk in diabetes: A multicenter study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月16日

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  • Özen Öz Gül,
  • Zeynep Cantürk,
  • Sadettin Öztürk,
  • Nilüfer Özdemir,
  • Dilek Kılınç Candemir,
  • Burak Özbaş,
  • Filiz Mercantepe,
  • Filiz Mercan Sarıdaş,
  • Erhan Hocaoğlu,
  • Onur Elbasan,
  • Burcu Candemir,
  • Berrin Çetinarslan,
  • Ali Saklamaz,
  • Şerife Ezgi Doğan,
  • Elif Seray Korkmaz,
  • Sezin Doğan Çakır,
  • Hülya Kaynak,
  • Emine Kartal Baykan,
  • Mehmet Güven,
  • Murat Çalapkulu,
  • Onur Daloğlu,
  • Yasemin Aydoğan Ünsal,
  • Özlem Kanburoğlu,
  • Selin Çakmak Demir,
  • Dilek Gogas Yavuz,
  • Zeynep Çetin,
  • Ayşen Akkurt Kocaeli,
  • Zeliha Hekimsoy,
  • Mithat Mızrak,
  • Zehra Candan,
  • Erman Çakal,
  • Gülce Ecem Kılıç,
  • Göknur Yorulmaz,
  • Mine Adaş,
  • Zeliha Yarar,
  • Pınar Akhanlı,
  • Metin Güçlü,
  • Muhammet Cüneyt Bilginer,
  • Adnan Batman,
  • Sevdenur Taşkın,
  • Sema Hepşen,
  • Aysen Akalın,
  • Serpil Çiftel,
  • Anna Abbasgholizadeh,
  • Oğuzhan Deyneli,
  • Zehra Erdemir,
  • Gamze Gelir Çavdar,
  • Yusuf Kayhan,
  • Taner Bayraktaroğlu,
  • Güven Özkaya

摘要

Summary

We assessed bone health in over 2500 adults with diabetes across Türkiye. T1DM patients had lower BMD, while T2DM patients showed higher fracture risk despite higher BMD. Several modifiable factors were linked to osteoporosis. These findings support personalized bone assessments in diabetic populations.

Background

Diabetes mellitus (DM) is a recognized risk factor for bone fragility. While type 1 DM (T1DM) is typically associated with low bone mineral density (BMD), type 2 DM (T2DM) often presents with higher BMD despite increased fracture risk. Large-scale comparative studies remain limited.

Objective

To evaluate bone health, including osteopenia, osteoporosis, and fracture risk, in adults with T1DM and T2DM.

Methods

This multicenter, cross-sectional study included 2562 patients (224 with T1DM, 2338 with T2DM) from 27 centers across Türkiye. BMD was assessed using dual-energy X-ray absorptiometry (DXA) and fracture risk was estimated via the Turkish-adapted FRAX® algorithm in patients aged ≥ 40 years. Multinomial logistic regression was used to identify independent predictors of low BMD.

Results

Osteoporosis prevalence was 5.5% in T1DM and 9.6% in T2DM (femoral neck T-score). Adjusted BMD was significantly lower in T1DM at all skeletal sites, while FRAX-based fracture risk and fall-related fractures were higher in T2DM. Independent predictors of osteoporosis included older age, female sex, lower BMI, reduced calcium levels, corticosteroid use, albuminuria, hypertension, and less frequent sodium-glucose cotransporter-2 (SGLT2) inhibitor use. T1DM was independently associated with osteopenia but not osteoporosis.

Conclusion

This multicenter study demonstrates distinct patterns of BMD and fracture risk across diabetes subtypes and supports individualized bone health assessment in routine diabetes care.