Osteoporosis risk prediction in patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease
DOI:
https://doi.org/10.14739/2310-1210.2020.5.214733Keywords:
osteoporosis, type 2 diabetes mellitus, non-alcoholic fatty liver disease, diagnosisAbstract
The aim of the study is to optimize the method of osteoporosis (OP) risk prediction in patients with type 2 diabetes mellitus (DM) and non-alcoholic fatty liver disease (NAFLD) by using specific and sensitive diagnostic criteria.
Materials and methods. The design of the risk prediction method of the OP development in patients with type 2 DM and NAFLD was conducted by using the most significant diagnostic indicators. The calculation method of the OP risk probability in patients with type 2 DM and NAFLD was developed by using statistical methods of multivariate factor analysis and logistic regression. The method was evaluated in the Clinic of the State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine” in 51 patients, whose average age was 63.2 ± 0.99 years with the average duration of type 2 DM 7.84 ± 0.68 years.
Results. In order to establish the diagnostic accuracy of the proposed method of the OP development risk prediction in patients with type 2 DM and NAFLD, the data on all examined patients were analyzed and the following diagnostic characteristics were obtained: the sensitivity of the developed method is 88.23 %, the probability of a negative result with a negative prognosis, or the specificity of the developed method, is 70.58 %; the accuracy (the proportion of true-positive results and true-negative results) is 82.35 %, the odds ratio is 18.37.
Conclusions. The proposed OP risk prediction method in patients with type 2 DM and NAFLD allows obtaining reliable predictions with sufficient accuracy for practical use. The application of this method will serve beyond assessing the risk of OP development, but also to provide timely treatment with drugs aimed to prevent the OP progression and to avoid complications, thereby reducing disability and influencing the quality of life.
References
International Diabetes Federation (n.d.). IDF Diabetes Atlas 2019. 9th edition. IDF. https://www.diabetesatlas.org/en/resources/
Cheng, P C., Hsu, S. R., Cheng, Y. C., & Liu, Y. H. (2017). Relationship between hemoglobin glycation index and extent of coronary heart disease in individuals with type 2 diabetes mellitus: a cross-sectional study. PeerJ, 5, Article e3875. https://doi.org/10.7717/peerj.3875
Han, T. S., & Lean, M. E. (2016). A clinical perspective of obesity, metabolic syndrome and cardiovascular disease. Journal of the Royal Society of Medicine Cardiovascular Disease, 5, Article 2048004016633371. https://doi.org/10.1177/2048004016633371
Tkach, S., & Cheverda, T. (2016). Nealkoholna zhyrova khvoroba pechinky: poshyrenist, pryrodnyi perebih, suchasni pidkhody do diahnostyky ta likuvannia [Non-alcoholic fatty liver disease: incidence, natural history, new approaches to diagnostic and treatment]. Klinichna endokrynolohiia ta endokrynna khirurhiia, (1), 60-71. https://doi.org/10.24026/1818-1384.1(53).2016.75839 [in Ukrainian].
Trikkalinou, A., Papazafiropoulou, A. K., & Melidonis, A. (2017). Type 2 diabetes and quality of life. World Journal of Diabetes, 8(4), 120-129. https://doi.org/10.4239/wjd.v8.i4.120
Wu, Y., Ding, Y., Tanaka, Y., & Zhang, W. (2014). Risk Factors Contributing to Type 2 Diabetes and Recent Advances in the Treatment and Prevention. International Journal of Medical Sciences, 11(11), 1185-1200. https://doi.org/10.7150/ijms.10001
Fox, C. S., Golden, S. H., Anderson, C., Bray, G. A., Burke, L. E., de Boer, I. H., Deedwania, P., Eckel, R. H., Ershow, A. G., Fradkin, J., Inzucchi, S. E., Kosiborod, M., Nelson, R. G., Patel, M. J., Pignone, M., Quinn, L., Schauer, P. R., Selvin, E., & Vafiadis, D. K. (2015). Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association. Diabetes Care, 38(9), 1777-1803. https://doi.org/10.2337/dci15-0012
Ocheretina, R. Y. (2015). Vzaimosvyaz' morfofunktsional'nogo sostoyaniya pecheni s metabolizmom kostnoi tkani [Correlation of liver morphofunctional state with bone tissue metabolism]. Uspekhi sovremennogo estestvoznaniya, (2), 89-93. [in Russian].
Povoroznyuk, V. V., Grygorieva, N. V., Korzh, M. O., Strafun, S. S., Kanis, J. A., Johansson, H., McCloskey, E. V., Vaida, V. M., Klymovytsky, F. V., Vlasenko, R. O., & Forosenko, V. S. (2016). Epidemiolohiia perelomiv proksymalnoho viddilu stehnovoi kistky v Ukraini: rezultaty dvokh retrospektyvnykh doslidzhen [Epidemiology of proximal femur fractures in Ukraine: results of two retrospective studies]. Ortopediya, travmatologiya i protezirovanie, (4), 68-74. [in Ukrainian].
Luxon, B. A. (2010). Bone Disorders in Chronic Liver Diseases. Current Gastroenterology Reports, 13(1), 40-48. https://doi.org/10.1007/s11894-010-0166-4
Danford, C. J., Trivedi, H. D., & Bonder, A. (2019). Bone Health in Patients With Liver Diseases. Journal of Clinical Densitometry, 23(2), 212-222. https://doi.org/10.1016/j.jocd.2019.01.004
Guañabens, N., & Parés, A. (2018). Osteoporosis in chronic liver disease. Liver International, 38(5), 776-785. https://doi.org/10.1111/liv.13730
Sveshnikov, A. A., & Hvostova, S. A. (2016). Osteoporoz: novye nauchnye izyskaniya i sposoby lecheniya [Osteoporosis: new scientific findings and methods of treatment]. Mezhdunarodnyi zhurnal prikladnykh i fundamental'nykh issledovanii, (7-1), 54-58. [in Russian].
Mistyakov, M. V., Bardimova, T. P., & Tsyretorova, S. S. (2015). Sakharnyi diabet i osteoporoz [Diabetes mellitus and osteoporosis]. Sibirskii meditsinskii zhurnal, 137(6), 47-52. [in Russian].
Yalochkina, T. O., & Belaya, Z. E. (2017). Nizkotravmatichnye perelomy i kostnoe remodelirovanie pri sakharnom diabete 2 tipa [Fragility fractures and bone remodeling in type 2 diabetes mellitus]. Ozhirenie i metabolizm, 14(3), 11-18. https://doi.org/10.14341/omet2017311-18 [in Russian].
Kanazawa, I., Takeno, A., Tanaka, K., Yamane, Y., & Sugimoto, T. (2018). Osteoporosis and vertebral fracture are associated with deterioration of activities of daily living and quality of life in patients with type 2 diabetes mellitus. Journal of Bone and Mineral Metabolism, 37(3), 503-511. https://doi.org/10.1007/s00774-018-0948-6
Wang, X., Li, W., Zhang, Y., Yang, Y., & Qin, G. (2015). Association between vitamin D and non-alcoholic fatty liver disease/non-alcoholic steatohepatitis: results from a meta-analysis. International Journal of Clinical and Experimental Medicine, 8(10), 17221-17234.
Barchetta, I., Del Ben, M., Angelico, F., Di Martino, M., Fraioli, A., La Torre, G., Saulle, R., Perri, L., Morini, S., Tiberti, C., Bertoccini, L., Cimini, F. A., Panimolle, F., Catalano, C., Baroni, M. G., & Cavallo, M. G. (2016). No effects of oral vitamin D supplementation on non-alcoholic fatty liver disease in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled trial. BMC Medicine, 14, Article 92. https://doi.org/10.1186/s12916-016-0638-y
Eliades, M., Spyrou, E., Agrawal, N., Lazo, M., Brancati, F. L., Potter, J. J., Koteish, A. A., Clark, J. M., Guallar, E., & Hernaez, R. (2013). Meta-analysis: vitamin D and non-alcoholic fatty liver disease. Alimentary Pharmacology & Therapeutics, 38(3), 246-254. https://doi.org/10.1111/apt.12377
Kwok, R. M., Torres, D. M., & Harrison, S. A. (2013). Vitamin D and nonalcoholic fatty liver disease (NAFLD): Is it more than just an association? Hepatology, 58(3), 1166-1174. https://doi.org/10.1002/hep.26390
Upala, S., Jaruvongvanich, V., Wijarnpreecha, K., & Sanguankeo, A. (2016). Nonalcoholic fatty liver disease and osteoporosis: a systematic review and meta-analysis. Journal of Bone and Mineral Metabolism, 35(6), 685-693. https://doi.org/10.1007/s00774-016-0807-2
Niu, Y., Zhang, W., Yang, Z., Li, X., Fang, W., Zhang, H., Wang, S., Zhou, H., Fan, J., Qin, L., & Su, Q. (2016). Plasma osteoprotegerin levels are inversely associated with nonalcoholic fatty liver disease in patients with type 2 diabetes: A case–control study in China. Metabolism, 65(4), 475-481. https://doi.org/10.1016/j.metabol.2015.12.005
Filip, R., Radzki, R., & Bieńko, M. (2018). Novel insights into the relationship between nonalcoholic fatty liver disease and osteoporosis. Clinical Interventions in Aging, 13, 1879-1891. https://doi.org/10.2147/cia.s170533
Chen, H.-J., Yang, H.-Y., Hsueh, K.-C., Shen, C.-C., Chen, R.-Y., Yu, H.-C., & Wang, T.-L. (2018). Increased risk of osteoporosis in patients with nonalcoholic fatty liver disease. Medicine, 97(42), Article e12835. https://doi.org/10.1097/md.0000000000012835
Han, J., & Hahn, M. H. (2016). Proximal Femoral Geometry as Fracture Risk Factor in Female Patients with Osteoporotic Hip Fracture. Journal of Bone Metabolism, 23(3), 175-182. https://doi.org/10.11005/jbm.2016.23.3.175
Dzizinskii, A. A., Khramtsova, N. A., Men'shikova, L. V., & Mikhalevich, I. M. (2004). Sposob prognozirovaniya perelomov proksimal'nogo otdela bedrennoi kosti [A method for predicting fractures of the proximal femur]. Russia Patent RU 2238037. http://www.freepatent.ru/patents/2238037
Trifonova, E. B., & Gyul'nazarova, S. V. (2002). Sposob diagnostiki tyazhesti osteoporoza [A method for diagnosing the severity of osteoporosis]. Russia Patent RU 2194994. http://www.freepatent.ru/patents/2194994
Zakharov, I. S. (2016). Optimizatsiya kompleksnoi diagnostiki i prognozirovaniya postmenopauzal'nogo osteoporoza. (Avtoref. dis. … doc. med. nauk). [Optimization of a comprehensive diagnosis and prognosis of postmenopausal osteoporosis]. (Extended abstract of doctoral thesis). St. Petersburg. [in Russian].
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