SAT-795 Diabetic Paradox in Bone Health: The Role of Radiofrequency Echographic Multi Spectrometry (REMS) technology for bone health assessment

Abstract Disclosure: E. Luna: None. F. Conversano*: None. F. Lombardi*: None. M. Muratore*: None. P. Pisani*: None. C. Stomaci*: None. S. Casciaro*: None. Background: Type 2 Diabetes Mellitus (T2DM) is a metabolic disease characterized by high blood glucose levels due to insulin resistance. Globally, approximately 462 million people are affected by T2DM, with significant socio-economic implications. Numerous studies have already established a link between T2DM and bone health, highlighting a markedly increased risk of fractures (up to 5 times higher than in healthy individuals). However, despite the elevated fracture risk, bone mass and strength in individuals with T2DM often remain within the normal range or even show increases. This phenomenon, known as the “diabetic paradox”, emphasizes the need to assess both bone quality and quantity. The mechanisms underlying bone involvement seem to involve the glycosylation of collagen by excess of glucose, which disrupts bone structure and increases fragility. Additionally, obesity, a common condition in T2DM, plays a crucial role by inducing inflammatory responses that further contribute to bone degradation. Objectives: The objective of this study is to assess the impact of T2DM on bone quality by using the Radiofrequency Echographic Multi Spectrometry (REMS)-based parameter Fragility Score (FS). REMS is an advanced ultrasound technology that assesses both bone quantity and quality through a simple scan of reference sites such as lumbar spine and femoral neck. The FS, which ranges from 0 to 100, reflects skeletal fragility independently of Bone Mineral Density (BMD), with a score of 100 indicating maximum similarity to a fractured bone model and 0 representing a healthy model. Methods: A total of 45T2DM patients (both genders) were evaluated and compared to a matched group of healthy controls (HC), for gender, ethnicity, age, and Body Mass Index (BMI). All patients underwent lumbar spine measurements (L1-L4), and differences in FS between the groups were analyzed using a t-test. Results: The mean age and BMI of the T2DM group and HC group were as follows: 69.7±10.7 y and 26.6±4.1 kg/m² for the T2DM group, and 69.5±10.8 y and 26.8±3.9 kg/m² for the HC group. The average FS at the lumbar spine was significantly higher in T2DM patients (53.6±17.0) compared to HC (49.8±16.7), with a mean difference of -3.8 ± 16.7. Conclusion: This study highlights the impaired bone quality in T2DM patients compared to healthy controls. The FS parameter provided by REMS offers a reliable method for assessing bone quality in this population, making it a valuable tool for bone health monitoring in clinical routine. Presentation: Saturday, July 12, 2025