Bone Abstracts

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance, progressive impairment of insulin secretion, and persistent hyperglycaemia. Despite having normal or even elevated bone mineral density (BMD) as measured by conventional techniques such as DXA, patients with T2DM exhibit a markedly increased fracture riskup to five times higher than that of non-diabetic individuals, highlighting the need for a more comprehensive skeletal assessment that accounts for both bone quantity and bone quality. The aim of this study was to evaluate BMD in patients with T2DM using Radiofrequency Echographic Multi Spectrometry (REMS) in comparison with DXA. REMS is a portable, non-ionizing technique that is not affected by imaging artefacts and has demonstrated high sensitivity, specificity, and strong correlation with DXA. In addition, the REMS-derived Fragility Score (FS) provides information on bone quality and skeletal fragility.

Methods: Caucasian men and women with a diagnosis of T2DM who underwent both DXA and REMS examinations at the same axial skeletal site (proximal femur) were included. Bone quantity was assessed using both REMS-BMD and DXA-BMD, while bone quality was evaluated using REMS-FS. Differences between BMD values obtained with the two techniques were analysed using paired t-tests.

Results: A total of 43 patients were included (mean age: 72.9±7.3 years). Mean REMS-BMD and DXA-BMD values were 0.793±0.108 g/cm² vs. 0.881±0.152 g/cm² at the total hip (p 0.001) and 0.648±0.099 g/cm² vs. 0.749±0.149 g/cm² at the femoral neck (p 0.0001), respectively. REMS-based bone quality assessment yielded a mean Fragility Score of 26.7±6.9, indicating a mildly compromised bone microarchitectural framework.

Conclusion: This study demonstrates significant differences between REMS and DXA in the assessment of BMD in patients with T2DM, with REMS consistently yielding lower BMD values and consequently recognizing a higher prevalence of osteoporosis. Moreover, the inclusion of the Fragility Score allows evaluation of bone quality and skeletal fragility, providing additional insight into the effects of T2DM on bone health. These findings support the potential role of REMS as a valuable tool to improve osteoporosis diagnosis and fracture risk assessment in patients with T2DM.