ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ YẾU TỐ NGUY CƠ GÃY XƯƠNG ĐỐT SỐNG Ở PHỤ NỮ MÃN KINH MẮC ĐÁI THÁO ĐƯỜNG TÍP 2

Abstract

Background: Vertebral fractures, like hypertension and other chronic diseases, often progress silently but may cause serious consequences if not detected and treated promptly. Diabetes mellitus increases fracture risk through multiple mechanisms. This study aimed to clarify the characteristics and risk factors of vertebral fractures in postmenopausal women with type 2 diabetes mellitus, contributing to early detection and timely intervention to prevent disabling complications. Objectives: This study aimed to achieve two objectives: (1) To compare clinical and subclinical characteristics between postmenopausal women with type 2 diabetes mellitus with and without vertebral fractures; (2) To identify risk factors for vertebral fractures in this population. Methods: A cross-sectional study was conducted on postmenopausal women diagnosed with type 2 diabetes mellitus who were receiving treatment at the Department of Endocrinology and the Department of Musculoskeletal Medicine, Nguyen Tri Phuong Hospital, from March to July 2024. Clinical and subclinical data were collected to compare characteristics between groups with and without vertebral fractures and to identify associated risk factors. Thoracolumbar spine X-rays in anteroposterior and lateral views were used to diagnose vertebral fractures. Results: In this study, 29 out of 128 participants were confirmed to have vertebral fractures based on spinal X-ray films. The fracture group had higher age, longer duration of menopause, and longer duration of diabetes, as well as a significantly higher prevalence of diabetic retinopathy compared to the non-fracture group (p < 0.05). Additionally, the T-score at the femoral neck was significantly lower in the fracture group (p < 0.05). Logistic regression analysis revealed that postmenopausal women with type 2 diabetes mellitus and diabetic retinopathy had a 6.4-fold increased risk of vertebral fractures compared to those without this complication (95% CI: 2.29–17.91; p < 0.001). Furthermore, every 5-year increase in diabetes duration was associated with a 1.53-fold increase in fracture risk (95% CI: 1.05–2.23; p = 0.025). Bone mineral density at both the femoral neck and lumbar spine was not significantly associated with vertebral fractures. Conclusion: Postmenopausal women with type 2 diabetes mellitus represent a high-risk group for vertebral fractures. Therefore, timely screening and intervention strategies should be implemented, particularly for those with diabetic retinopathy and a long duration of diabetes.