Prevalence and associated factors of osteoporosis in type 2 diabetes mellitus patients: a cross-sectional study

Osteoporosis is increasingly recognized as an important comorbidity among patients with type 2 diabetes mellitus (T2DM). However, data regarding its prevalence and associated factors in older Iranian diabetic patients remain limited. The current study was designed to assess the prevalence of osteoporosis and associated factors in T2DM patients over 55 Years of age. In this cross-sectional study, 102 patients with T2DM aged over 54 years were recruited from endocrinology clinics and wards of Imam Reza and Sina Hospitals in Tabriz, Iran. Demographic, clinical, laboratory, and medication-related data were collected. Bone mineral density was assessed using dual-energy X-ray absorptiometry and osteoporosis was defined based on lumbar spine and/or femoral neck T-scores ≤ -2.5. In cases of degenerative changes affecting lumbar spine measurements, values from the femoral neck were prioritized. Logistic regression analyses were performed to identify factors associated with osteoporosis. The prevalence of osteoporosis was 32.4% (95% CI: 23.4–42.3%). Female sex was significantly associated with osteoporosis (OR = 4.84, 95% CI: 1.67–14.01, P = 0.004). Lower estimated glomerular filtration rate (eGFR, mL/min/1.73m 2 ) was also significantly associated with osteoporosis (OR = 0.96, 95% CI: 0.94–0.98, P = 0.004). In multivariable analysis, female sex (adjusted OR = 3.34, P = 0.035) and lower eGFR (adjusted OR = 0.97, P = 0.037) remained independently associated with osteoporosis. These findings highlight the importance of integrating bone health into the routine management of older adults with T2DM. Particular attention to women and patients with impaired renal function may support earlier identification of those at greater skeletal risk. Prospective multicenter studies are warranted to improve risk stratification and inform appropriate osteoporosis screening strategies in this population.