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Editor's Correspondence |

Is Bone Mineral Density Paradoxically Increased in Early Stage of Diabetic Nephropathy?

Hiroyuki Koshiyama, MD, PhD; Kiyoshi Tanaka, MD, PhD; Kazuwa Nakao, MD, PhD
Arch Intern Med. 1999;159(10):1145. doi:.
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Bone mineral density (BMD) is known to show a progressive loss in end-stage renal failure,1 but there have been few reports about the BMD in early stage of renal failure. We investigated the change of BMD in subjects with early stage of diabetic nephropathy. The BMDs of L2 to L4 were measured with dual-energy x-ray absorptiometry (QDR-4500; Hologic Co, Waltham, Mass), as previously reported,2,3 in 492 Japanese subjects with type 2 diabetes (206 men and 286 women, mean ± SE age, 61.7 ± 0.5 years). Early stage of nephropathy was defined as consistent proteinuria without any increase in serum creatinine level. None of the patients had received glucocorticoid, estrogen, or thiazide, which are known to influence BMD. There was no significant difference in body mass index, age, insulin dosage, or glycemic control (hemoglobin A1c) between the subjects with nephropathy (n=145) and those without (n=347). The mean ± SE BMD values were higher in the subjects with early-stage nephropathy than in those without (0.973 ± 0.016 g/cm2 vs 0.909 ± 0.010 g/cm2; P<.001). The percentage values of BMD compared with age- and sex-matched control data were also higher in the subjects with early-stage nephropathy than in those without (112.0% ± 1.7% vs 105.3% ± 1.0%, P<.001).

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