Risk of fractures in patients with osteoporosis associated with chronic heart failure and type 2 diabetes mellitus

Introduction and Aim: Although the pathophysiological processes underlying the association between congestive heart failure (CHF) and osteoporosis (OP) are unknown, there is evidence that several changes observed in CHF may play a role in bone loss. The objective of the study is to examine the impact of soluble TNF-alpha receptor 1 (sR1-TNF-alpha) and soluble TNF-alpha receptor 2 (sR2-TNF-alpha) on the risk of fractures in patients with OP associated with CHF and type 2 diabetes mellitus (T2DM). Methods: This study included 178 women aged 50–65 years, divided into four groups. Group 1 consisted of 48 women diagnosed with HF and T2DM. Group 2 included 93 patients with OP and HF. Group 3 consisted of 37 women with OP, HF, and T2DM. Results: The levels of sR1-TNF-alpha and sR2-TNF-alpha in patient groups 1 through 3 were significantly higher than in the control group (p<0.01). Furthermore, it was demonstrated that patients in group 3 had much greater levels of both receptors than those in groups 1 and 2. Conclusion: High levels of sR1-TNF-alpha and sR2-TNF-alpha in postmenopausal women with CHF are associated with an increased risk of a poor outcome during OP.