SAT-786 - Clinical Predictors of Osteopenic Syndrome in Men with Type 2 Diabetes Mellitus in the Republic of Tajikistan

Abstract
Objective. To identify clinical, laboratory, and instrumental predictors of osteopenic syndrome in men with type 2 diabetes mellitus (T2DM) in the Republic of Tajikistan.
Materials and Methods. This study included 100 indigenous men from the Republic of Tajikistan: 50 patients with T2DM and 50 men without impaired carbohydrate metabolism (control group). The examination consisted of medical history taking; assessment of risk factors for osteoporosis and aging; evaluation of clinical and demographic parameters (age, body mass index, duration of diabetes, and history of fractures); and biochemical and hormonal testing. Bone mineral density (BMD) was assessed using densitometry.
Results. The main risk factors for osteoporotic changes were dietary characteristics common in the region, including low intake of protein, calcium, and vitamin D, as well as unhealthy habits such as cigarette smoking (up to 6 cigarettes per day) and excessive consumption of strong tea (more than 2 liters per day). In addition, longer duration of T2DM and the presence of diabetic complications contributed to decreased BMD. The negative effect of excessive green tea consumption may be related to polyphenols, which stimulate osteoblastic activity at low concentrations but suppress it at high concentrations. However, the association between high tea consumption and fracture risk remains unclear and requires further investigation.
In men with T2DM, normal BMD values were observed in 68% of cases, while reduced BMD was detected in 32%. Osteopenia was diagnosed in 24% of patients, and osteoporosis in 8%. In the control group, reduced BMD was found in 18% of individuals, including osteopenia in 14% and osteoporosis in 4%. Both the prevalence and severity of BMD reduction were higher in patients with T2DM than in the control group.
Conclusion. Men with type 2 diabetes mellitus in the Republic of Tajikistan have significantly lower bone mineral density compared with men without diabetes. Free testosterone deficiency is associated with a more pronounced reduction in BMD in the lumbar spine and femoral neck, indicating its role in key skeletal sites at risk for osteoporotic fractures. These findings highlight the importance of early screening for osteopenia in patients with T2DM, including routine hormonal assessment, to ensure timely prevention and treatment.

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