Relationship Between Bone Mass Density and Nutritional Status of Women Diagnosed with Type 2 Diabetes Mellitus in Charsadda
Bone Mass Density and Nutritional Status of Women Diagnosed with Type 2 Diabetes Mellitus
DOI:
https://doi.org/10.54393/df.v6i2.174Keywords:
Bone Mass Density, Quantitative Ultrasound Scan, Calcium, Nutrition, Type 2 Diabetes MellitusAbstract
The prevalence of low bone density among women is common but remains under-documented. Objectives: To assess bone mass density (BMD) levels and their relationship with nutritional status in type 2 diabetes mellitus (T2DM) women visiting the NEAT Clinic in Charsadda, Khyber Pakhtunkhwa (KPK). Methods: Using an observational, cross-sectional design, data were collected from 408 women through a structured self-reported questionnaire covering osteoporosis risk factors, sociodemographic information, anthropometrics, general health, BMD, and dietary intake. BMD was measured via Quantitative Ultrasound Scan (QUS) at the calcaneus using the Sahara clinical bone sonometer. Initially, 605 women expressed interest, but data were collected for 450 participants due to drop-out and incomplete questionnaires. Results: The mean T-score was –1.76 ± 0.81 (median: –1.72), ranging from –3.5 to 1.4. Women classified as normal, osteopenic, and osteoporotic had mean T-scores of –0.42 ± 0.43, –1.66 ± 0.34, and –2.66 ± 0.25, respectively. The prevalence of osteopenia was 59.8% and that of osteoporosis was 22.2%, while only 18% had normal BMD. QUS scores showed significant correlations (p<0.05) with age, menopausal duration, BMI, waist-hip ratio (WHR), and education level. Nutritional factors such as energy, protein, calcium, and phosphorus intake were also positively associated with QUS scores. Conclusions: The study reveals a high prevalence of osteopenia and osteoporosis among women in this population, with bone health strongly linked to both demographic and dietary factors.
References
Nandiraju D and Ahmed I. Human Skeletal Physiology and Factors Affecting Its Modeling and Remodeling. Fertility and Sterility. 2019 Nov; 112(5): 775-81. doi: 10.1016/j.fertnstert.2019.10.005. DOI: https://doi.org/10.1016/j.fertnstert.2019.10.005
Suhett LG, Filgueiras MD, De Novaes JF, Sukumar D. Role of Diet Quality in Bone Health in Children and Adolescents: A Systematic Review. Nutrition Reviews. 2024 Jan; 82(1): 47-59. doi: 10.1093/nutrit/nuad036. DOI: https://doi.org/10.1093/nutrit/nuad036
Skalny AV, Aschner M, Tsatsakis A, Rocha JB, Santamaria A, Spandidos DA et al. Role of Vitamins Beyond Vitamin D 3 in Bone Health and Osteoporosis. International Journal of Molecular Medicine. 2024 Jan; 53(1): 1-21. doi: 10.3892/ijmm.2023.5333. DOI: https://doi.org/10.3892/ijmm.2023.5333
Murali RR and Smith AA. Nutraceuticals for the Management of Osteoporosis: A Review. Degrés. 2024 Apr; 9(4).
Ciosek Ż, Kot K, Kosik-Bogacka D, Łanocha-Arendarczyk N, Rotter I. The Effects of Calcium, Magnesium, Phosphorus, Fluoride, and Lead on Bone Tissue. Biomolecules. 2021 Apr; 11(4): 506. doi: 10.3390/biom11040506. DOI: https://doi.org/10.3390/biom11040506
Savarino, G., Corsello, A., & Corsello, G. (2021). Macronutrient balance and micronutrient amounts through growth and development. Italian journal of pediatrics, 47(1), 109. doi.org/10.1186/s13052-021-01061-0 DOI: https://doi.org/10.1186/s13052-021-01061-0
Mosca LN, Goldberg TB, da Silva VN, Kurokawa CS, Rizzo AC, da Silva CC et al. The Impact of Excess Body Fat on Bone Remodeling in Adolescents. Osteoporosis International. 2017 Mar; 28(3): 1053-62. doi: 10.1007/s00198-016-3838-6. DOI: https://doi.org/10.1007/s00198-016-3838-6
Rahman HU and Alam I. Nutritional and Vitamin D Status of University Students in Khyber Pakhtunkhwa, Pakistan: A Cross-Sectional Study: Nutritional and Vitamin D Status in Students. Diet Factor (Journal of Nutritional and Food Sciences). 2024 Dec: 19-24. doi: 10.54393/df.v5i04.159. DOI: https://doi.org/10.54393/df.v5i04.159
Wáng, Y. X. J., Griffith, J. F., Blake, G. M., Diacinti, D., Xiao, B. H., Yu, W., ... & Kwok, T. C. (2024). Revision of the 1994 World Health Organization T-score definition of osteoporosis for use in older East Asian women and men to reconcile it with their lifetime risk of fragility fracture. Skeletal Radiology, 53(4), 609-625. https://doi.org/10.1007/s00256-023-04453-3 DOI: https://doi.org/10.1007/s00256-023-04481-7
de Bakker, C. M., Tseng, W. J., Li, Y., Zhao, H., & Liu, X. S. (2017). Clinical evaluation of bone strength and fracture risk. Current osteoporosis reports, 15(1), 32-42. doi.org/10.1007/s11914-017-0346-3 DOI: https://doi.org/10.1007/s11914-017-0346-3
Mozammal, M., & Rahaman, K. S. (2025). Screening of osteoporosis and risk of osteoporotic fracture among the population in old Dhaka city using Quantitative Ultrasound (QUS) and Fracture Risk Assessment Tool (FRAX). Asian Journal of Medical and Biological Research, 11(3), 49-58. doi.org/10.3329/ajmbr.v11i3.78477 DOI: https://doi.org/10.3329/ajmbr.v11i3.78477
Defeudis, G., Cardinali, L., Eftekhariranjbar, S., Massari, M. C., & Migliaccio, S. (2024). Male osteoporosis: the impact of lifestyle, from nutrition to physical activity. Journal of Endocrinological Investigation, 1-9. doi.org/10.1007/s40618-024-02517-w DOI: https://doi.org/10.1007/s40618-024-02517-w
Sözen T, Özışık L, Başaran NÇ. An Overview and Management of Osteoporosis. European Journal of Rheumatology. 2016 Dec; 4(1): 46. doi: 10.5152/eurjrheum.2016.048. DOI: https://doi.org/10.5152/eurjrheum.2016.048
Hernlund E, Svedbom A, Ivergård M, Compston J, Cooper C, Stenmark J et al. Osteoporosis in the European Union: Medical Management, Epidemiology and Economic Burden: A Report Prepared in Collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Archives of Osteoporosis. 2013 Dec; 8(1): 136. doi: 10.1007/s11657-013-0136-1. DOI: https://doi.org/10.1007/s11657-013-0136-1
Kanis JA, Cooper C, Rizzoli R, Reginster JY, Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF). European Guidance for the Diagnosis and Management of Osteoporosis in Postmenopausal Women. Osteoporosis International. 2019 Jan; 30(1): 3-44. doi: 10.1007/s00198-018-4704-5. DOI: https://doi.org/10.1007/s00198-018-4704-5
Rizzoli R. Nutritional Aspects of Bone Health. Best Practice and Research Clinical Endocrinology and Metabolism. 2014 Dec; 28(6): 795-808. doi: 10.1016/j.beem.2014.08.003. DOI: https://doi.org/10.1016/j.beem.2014.08.003
Chen, H., Xiong, R., Cheng, J., Ye, J., Qiu, Y., Huang, S., ... & Zhu, H. (2024). Effects and mechanisms of polyunsaturated fatty acids on age-related musculoskeletal diseases: sarcopenia, osteoporosis, and osteoarthritis—a narrative review. Nutrients, 16(18), 3130. doi.org/10.3390/nu16183130 DOI: https://doi.org/10.3390/nu16183130
Weaver CM, Gordon CM, Janz KF, Kalkwarf HJ, Lappe JM, Lewis R et al. The National Osteoporosis Foundation’s Position Statement on Peak Bone Mass Development and Lifestyle Factors: A Systematic Review and Implementation Recommendations. Osteoporosis International. 2016 Apr; 27(4): 1281-386. doi: 10.1007/s00198-015-3440-3. DOI: https://doi.org/10.1007/s00198-015-3440-3
Cashman KD. Diet, Nutrition, and Bone Health. The Journal of Nutrition. 2007 Nov; 137(11): 2507S-12S. doi: 10.1093/jn/137.11.2507S. DOI: https://doi.org/10.1093/jn/137.11.2507S
Yeum, K. J., Ju, S., & Choe, U. (2025). Strategies for preventing bone loss in populations with insufficient calcium and vitamin D intake. Nutrition Research and Practice, 19(2), 155-169. doi.org/10.4162/nrp.2025.19.2.155 DOI: https://doi.org/10.4162/nrp.2025.19.2.155
Ahmad, I., Fatima, S., Luqman, M. W., Nazli, R., Habib, S. H., & Shah, I. (2022). Efficacy of multiple micronutrients supplementation on energy intake, calcium and vitamin D levels in underweight children. Journal of Ayub Medical College Abbottabad, 34(3 (SUPPL 1). doi.org/10.55519/JAMC-03-S1-9296 DOI: https://doi.org/10.55519/JAMC-03-S1-9296
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