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The aim of the study was to assess the 10-year risk of fractures (FRAX®), taking into account the values of bone mineral density (BMD) and trabecular bone index (TBI) in a population sample of women over 55 years of age with type 2 diabetes mellitus (DM2).Materials and methods. The study was carried out on the material of the population cohort of the international project HAPIEE (Novosibirsk). The design of the study is «case-control». Random groups of women aged 55-84 with and without DM2 were formed in combination with the presence or absence of fractures in the history (n = 103, group 4). Standardized questionnaires, anthropometry, densitometry (dual energy X-ray absorptiometry, DEXA), TBI and FRAX® fracture risk determination were performed on all people.Results. Women with DM2 who reported a history fracture (group 1) had lower T-criteria in the femoral neck than women with DM2 without fracture (group 2), p = 0.039. However, the history of fracture in women with DM2 was accompanied by higher T-criteria values (by 0.3-0.5 SD) in the vertebrae and hips compared to women without DM (group 3). We did not get a significant difference in the TBI parameter between all 4 groups studied. We also found no difference in the risk of repeated fracture among women with and without DM2 using FRAX® without densitometry and TBI-adjusted FRAX® (p = 0.841, p = 0.094, respectively). In group 1 with DM2 and fractures, the risk for FRAX with T-test was lower than in group 3 without DM with fractures (p = 0.034 for the main fractures, p = 0.002 for the hip).Conclusion. In the studied population groups «case-control» of women aged 55-84 years with diabetes mellitus and fractures in their history, the risk of FRAX® fractures is lower with regard to DEXA and does not differ significantly in terms of TBI in comparison with women without DM2 fractures. The data obtained reflect the difficulties in diagnostics and the need to search for additional methods of early diagnosis of increased risk of fractures in patients with DM2.

To study indicators of bone mineral densit (BMD) and trabecular bone score (TBS) and to reveal the 10-year fracture risk (FRAX®) taking into account the data obtained in persons with type 2 diabetes (DM2).A clinical study of the type of case - control. The study included 122 people with and without DM2. All persons were: questionnaires, anthropometry, densitometry, determination of TBS and fracture risk on the FRAX®.Persons with DM2 who underwent a fracture had lower T-score values in all areas except the spine, unlike those with DM2, but without fracture. However, persons with DM2 had a fracture at high values of T-score in vertebrae and hips in comparison with persons without DM. Using the TBS, we did not get a significant difference in any of the examined groups. We also found no differences in the risk of recurrent fractures among women with and without DM2 using FRAX® without densitometry and FRAX® adjusted for TBS. The values of FRAX® by T-score in the group of persons with DM with fractures were significantly lower (p=0.029 for major fractures, p=0.024 for hip fractures) than in persons without DM with fractures.Persons with DM2 and fractures have higher BMD values, lower than the FRAX fracture risk values adjusted for the T-score, do not differ significantly in TBS, which determines the difficulties in diagnosis, the need to find additional methods for early diagnosis of increased fracture risk in patients with DM2.Цель исследования. Изучить показатели минеральной плотности кости (МПК), трабекулярного костного индекса (ТКИ) и определить 10-летний риск переломов (FRAX®) с учетом полученных данных у лиц с сахарным диабетом 2-го типа (СД2). Материалы и методы. Проведено клиническое исследование по типу случай - контроль. Обследовано 122 человека с СД2 и без него. Всем лицам проведены: анкетирование, антропометрия, денситометрия, определение ТКИ и риска переломов по шкале FRAX®. Результаты и обсуждение. Лица с СД2, перенесшие перелом, имели более низкие показатели Т-критерия в шейке бедра, в отличие от лиц с СД2, но без перелома. Однако лица с СД2 имели перелом при больших значениях Т-критерия в позвонках и бедрах в сравнении с лицами без СД. Используя параметр ТКИ, мы не получили достоверной разницы ни в одной из обследованных групп. Также мы не нашли различий по риску повторных переломов среди женщин с СД2 и без него при помощи FRAX® без учета денситометрии и FRAX® с поправкой на ТКИ (р=0,841 и р=0,094, соответственно). Значения FRAX® с учетом Т-критерия в группе лиц с СД2 и переломами значимо ниже для основных переломов (р=0,029) и переломов бедра (р=0,024), чем у лиц без СД с переломами. Заключение. Лица с СД2 и переломами имеют более высокие значения МПК, более низкие значения риска переломов по FRAX® c поправкой на Т-критерий, не отличаются значимо по ТКИ, что определяет сложности в диагностике, необходимость поиска дополнительных методов ранней диагностики повышенного риска переломов у пациентов с СД2.