Format

Send to

Choose Destination
J Clin Endocrinol Metab. 2013 Nov;98(11):E1807-12. doi: 10.1210/jc.2013-2434. Epub 2013 Sep 13.

Diabetes microvascular disease and the risk for bisphosphonate-related osteonecrosis of the jaw: a single center study.

Author information

1
MD, PhD, Institute of Endocrinology, Diabetes, Metabolism, Department of Internal Medicine C, Rambam Medical Center and RB Rappaport Faculty of Medicine Technion, 12 Halia Street, Samy Ofer Tower no. 8 Fl, Haifa, 31096, Israel. Mogher.Khamaisi@joslin.harvard.edu.

Abstract

CONTEXT:

Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is a severe bone disease for which the exact pathogenesis mechanisms are not fully understood.

OBJECTIVE:

The objective of the study is to investigate a possible contribution of diabetes and microvascular disease to the pathophysiology of BRONJ.

DESIGN:

We identified 46 patients treated with bisphosphonates who were diagnosed with BRONJ based on their medical history during 2009 to 2012 and invited them for a dental assessment to confirm the diagnosis. Diabetes diagnosis was based on the American Diabetes Association criteria. The study group was compared to a control group of 38 patients treated with bisphosphonates without evidence of BRONJ.

SETTING:

The study was conducted at Rambam Health Care Campus, a referral center, Haifa, Israel.

RESULTS:

The results of our study showed that of the 46 patients with BRONJ, 31 (67.4%) had diabetes or impaired fasting glucose. The proportion with diabetes (37%) was higher than in the control group (26.3%; P = .009). The presence of diabetes or impaired fasting glucose increased the association with BRONJ by 2.78-fold (confidence interval = 1.27-6.07, P = .009). The prevalence of microvascular disease (neuropathy, retinopathy, nephropathy) was significantly higher in the BRONJ than in the control group (P = .01). The presence of diabetic nephropathy increased the association with BRONJ by 3.9-fold (confidence interval = 1.12-13.52, P = .02).

CONCLUSIONS:

This retrospective study suggests an association between diabetes, perhaps mediated through microvascular complications, and the development of BRONJ.

PMID:
24037883
DOI:
10.1210/jc.2013-2434
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center