Vnitr Lek 1989, 35(9):890-898

[Diabetic osteopathies. 3. The effect of diabetic complications on bone mineralization].

J Kocián, J Brunová

Using the method of assessment of clavicular corticodiaphyseal indices, the authors investigated the mineralization of bones in a group of 215 type II diabetics and in 40 type I diabetics. From both groups patients were selected without detectable complications and these were compared with a sub-group of patients who had some complications. Furthermore the authors investigated the number of fractures of vertebral bodies and other bones. The poorest results as regards mineralization were found in complications which interfere with calcium absorption: enteropathies, chronic pancreatitis, gastrectomies, renal disease and in women also liver disease, in both with impaired vitamin D conversion. An adverse effect was exerted also by a reduced dietary calcium intake in subjects with lactose intolerance or increased urinary calcium excretion in idiopathic hypercalciuria. Low values were recorded in all patients with motor disorders in angiopathies, otherwise this complication alone did not cause major decalcification. Hysterectomy with ovariectomy were manifested by decalcification only in women where the operation was performed during a certain period before the menopause. Neuropathy and retinopathy alone without impaired locomotor activity do not cause deterioration of the bone mineralization in diabetics. Surprisingly good results were achieved also in a group of diabetics with steatosis of the liver but without severe damage of liver function. With a exceptions the number of fractures of vertebral bodies and other bones correlated with the level of their mineralization.