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Abstract: TH-PO135

Serum Bicarbonate Is Associated with Bone Density Among Adults with Type 2 Diabetes: Results from the African American Diabetes Heart Study

Session Information

Category: Bone and Mineral Metabolism

  • 502 Bone and Mineral Metabolism: Clinical

Authors

  • Rao, Kishan, New York University Long Island School of Medicine, Mineola, New York, United States
  • Ancion, Jean Herold, New York University Long Island School of Medicine, Mineola, New York, United States
  • Akerman, Meredith, New York University Long Island School of Medicine, Mineola, New York, United States
  • Freedman, Barry I., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
  • Divers, Jasmin, New York University Long Island School of Medicine, Mineola, New York, United States
  • Khatri, Minesh, New York University Long Island School of Medicine, Mineola, New York, United States
Background


Osteoporosis is a significant cause of morbidity and mortality in the aging population. Individuals with type 2 diabetes (T2D) typically have higher bone density but also a higher rate of fractures. Serum bicarbonate may be a risk factor for bone loss, but studies are conflicting, and little is known about this relationship in T2D, especially in African Americans.

Methods


We examined the longitudinal relationship between serum bicarbonate and change in bone density in 300 participants with T2D in the African American - Diabetes Heart Study (AA-DHS). Serum bicarbonate was measured at baseline, and bone density was assessed using CT volumetric bone mineral density (vBMD) scans of the thoracic and lumbar spines at baseline and after an average of five years of follow up. Multivariate linear regression models assessed associations between baseline serum bicarbonate and longitudinal change in vBMD.

Results


At baseline, the cohort was 50% female, with a mean age of 55.1 years and a mean duration of diabetes of 10.2 years. The mean baseline serum bicarbonate was 26.6 (SD 3.3) mEq/L; the median baseline lumbar spine vBMD was 179.3 (IQR 148.2, 208.9) mg/cm3, and the median baseline thoracic spine vBMD was 204.9 (IQR 171.6, 231.9) mg/cm3. In adjusted analyses, every 1 mEq/L increase in baseline serum bicarbonate was significantly associated with a relative improvement in lumbar vBMD (1.04 (0.73, 1.36) mg/cm3, p < 0.01), as well as thoracic vBMD (1.36 (0.77, 1.94) mg/cm3, p < 0.01).

Conclusion

In this cohort of African-Americans with T2D, higher baseline serum bicarbonate levels associated with improved changes in bone density over time. Further studies are needed to determine if treatment of metabolic acidosis would lessen bone loss and fractures in this population.

Funding

  • Other NIH Support