Calcification of lower extremity arteries is related to the presence of osteoporosis in postmenopausal women with type 2 diabetes mellitus: a cross-sectional observational study.
It is unknown whether there is any relationship between extremity arterial macroangiopathy and osteoporosis in type 2 diabetic mellitus (T2DM) patients. We provide evidence to show the association between lower extremity arterial calcification and the presence of osteoporosis in postmenopausal T2DM women, but not in T2DM men of similar age.


PURPOSE
To investigate the relationship between lower extremity arterial calcification and the presence of osteoporosis in type 2 diabetic mellitus (T2DM) patients.


METHODS
We performed a retrospective cross-sectional study in patients with T2DM. They were assigned into two groups (patients with or without vascular calcification) in both sexes. Clinical characteristics, presence of osteoporosis, and bone metabolic markers were compared. Arterial calcification was determined by ultrasonography examination. Osteoporosis was defined based on the measurements from dual-energy X-ray absorptiometry. The relationship between the lower extremity arterial calcification and the presence of osteoporosis was analyzed. Statistical analysis was performed in SPSS 26.0.


RESULTS
A total of 933 T2DM patients (535 men ≥ 50 years old, and 398 postmenopausal women) were identified and analyzed. A significant association between arterial calcification and osteoporosis was only observed in women, with a higher prevalence of osteoporosis observed in women with calcification (40.8%) than in women without calcification (26.9%) (P = 0.004). Compared to women without calcification, women with calcification had lower bone mineral densities in the hip (P < 0.001) and femoral neck (P < 0.001). Ordinal logistic regression analysis showed that women with calcification had a nearly 2-fold increased risk for osteoporosis, even after adjusting for age, duration of T2DM, body mass index, pulse pressure, clearance of creatinine, glycosylated hemoglobin, and fasting C-peptide. Similar differences were not identified between men with and without calcification.


CONCLUSION
Calcification of lower extremity arteries is related with the presence of osteoporosis in postmenopausal T2DM women.
['Xu|Xiaojuan|X|', 'Zhang|Manna|M|', 'Fei|Zhaoliang|Z|', 'Sheng|Hui|H|', 'Qu|Shen|S|', 'Cui|Ran|R|http://orcid.org/0000-0003-4386-3140']
D015502:Absorptiometry, Photon D001158:Arteries D015519:Bone Density D003430:Cross-Sectional Studies D003924:Diabetes Mellitus, Type 2 D005260:Female D006801:Humans D035002:Lower Extremity D008297:Male D008875:Middle Aged D010024:Osteoporosis D015663:Osteoporosis, Postmenopausal D017698:Postmenopause D012189:Retrospective Studies
Calcification Lower extremity artery Osteoporosis Diabetes Bone mineral density