Background
Metabolic syndrome is associated with decreased physical activity and increased incidence of diabetes. Bone Mineral density (BMD) is positively associated with physical activity. Lower BMD is a risk factor for bone fractures. Whether subjects with metabolic syndrome alone show early signs of lower BMD and osteoporosis similar to those present in diabetic is not known.
Material and Method
This cross-sectional study in male veterans examined the BMD in 3458 non-diabetic men and 735 men with type 2 diabetes. In addition, the BMD changes in non-diabetic men without any metabolic syndrome were compared with non-diabetic men with metabolic syndrome as established by the criteria of the Adult Treatment Panel III.
Results
BMD of hip was significantly lower and incidence of osteoporosis higher in diabetic subjects compared with age and body mass index (BMI) matched non-diabetic subjects. BMD of AP spine was significantly higher in diabetic subjects compared with non-diabetics but similar when subjects were matched for BMI. Men with metabolic syndrome alone had higher osteoporosis and lower BMD of hip compared with those without metabolic syndrome.
Conclusions
The BMD of hip is lower in diabetics compared with age and BMI-matched non-diabetic men, and its level is similar in age and BMI-matched diabetics and non-diabetic men with metabolic syndrome. This suggests that both diabetes and metabolic syndrome are associated independently with higher osteoporosis and lower BMD of hip and are risk factors for increased incidence of hip fractures in men.

Keywords: Pelvic Bones - chemistry, Spine - chemistry, Osteoporosis - etiology, Metabolic Syndrome X - pathology, Diabetes Mellitus, Type 2 - pathology, Cross-Sectional Studies, Bone Density - physiology