Evaluating osteoporosis and its hormonal determinants in diabetic men: insights from a tertiary care setting in Pakistan

Objective: To evaluate the frequency of osteoporosis in male population with diabetes mellitus and to determine the association of osteoporosis with body mass index (BMI), smoking status, and gonadal status. Methods: This cross-sectional study was conducted at Lady Reading Hospital, Peshawar-Pakistan, from March 2023 to August 2023 with a sample size of 292 male diabetic participants. The sampling was done by non-probability convenient sampling. The inclusion criteria were diabetic male patients aged 25-80 years, whereas patients who were on corticosteroids and diagnosed cases of chronic heart failure, chronic kidney disease, respiratory failure, malignancy, connective tissue disorders, and fracture in the past 6 months were excluded from the study. Bone density and testosterone level were measured. The associations between descriptive data (age, gender, BMI, and gonadal status) and bone density were analyzed. Results: Out of 292 male diabetic participants with a mean age of 54.41 ± 8.71 years, 203 (69%) were smokers, 136 (47%) were overweight, 23 (7.8%) were obese, while 170 (58.2%) patients were having lower testosterone levels. Bone mineral density levels, measured with Dexa-Scan, demonstrated high frequency of osteoporosis in 120 (41.4 %) patients, and osteopenia in 106 (36.2 %) cases. Chi square statistics showed a significant association of osteoporosis with testosterone (p=0.001) and FSH levels (p=0.01) while such association was not significant with smoking status (p=0.2), LH level (p= 0.8) and BMI (p=0.1). Conclusion: High frequency of osteoporosis is a concern among the diabetic male population which is positively associated with hypogonadism, warranting early hormonal screening and intervention.