Highland Medical Research Journal

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Calcaneal ultrasound analysis of Nigerian adults with type 2 diabetes

Dorothy J Van der Jagt, Fabian Puepet, Regina M Trujillo, Annie Tran, Godwin E Imade, Robert H Glew


Objective: Type 2 diabetes is a major chronic disease in northern Nigeria. Although type 2diabetes is usually associated with increased bone mineral density, we were interested in estimating the bone mineral density of patients with type 2 diabetes in a region of the world where the usual calcium intake is well below the recommended dietary recommendations.

Research Design and Methods: A total of 50 patients (25M/25F) with type 2 diabetes and 50 healthy controls (20M/30F) were recruited at the Jos University Teaching hospital in Jos, Nigeria. Information regarding age, weight, height, medication use and duration of disease were obtained. Body composition analysis to determine lean body mass and body fat was performed using bioelectrical impedance analysis. Bone quality was assessed using quantitative ultrasound of the calcaneus. Glucose control was monitored using fasting glucose concentrations.

Results: Both male and females subjects with type 2 diabetes had superior ultrasound parameters including broadband ultrasound attenuation (BUA), speed of sound (SOS) and stiffness index (SI) relative to controls. However, there were no significant differences in these parameters between the subjects with diabetes and the controls. No associations between ultrasound parameters and body mass index or body composition were found for either the diabetic subjects or controls. A non-significant trend was observed between glucose control and SI for the female diabetic subjects. A statistically 2 significant correlation was obtained between SI and duration of disease but only for the female diabetic subjects.

Conclusions: Calcaneal ultrasound is a relatively inexpensive means for monitoring bone quality in patients with type 2 diabetes. The more favorable bone ultrasound parameters observed for patients with type 2 diabetes may be the result of the bonepromoting effects of hyperinsulinemia.

Keywords: type 2 diabetes, bone density, calcaneal ultrasound, stiffness index, hyperglycemia, Nigeria

Highland Medical Research Journal Vol. 3(2) 2005: 1-14
AJOL African Journals Online