Vikram V Shanbhogue1, Stinus Hansen2, Morten Frost2, Niklas Rye Jørgensen2, Anne Pernille Hermann2, Jan Erik Henriksen2, Kim Brixen2. 1. Department of EndocrinologyOdense University Hospital, Institute of Clinical Research, University of Southern Denmark, Kloevervaenget 6.1.sal, DK-5000 Odense C, DenmarkDepartments of Diagnostics and Medicine MResearch Center for Ageing and Osteoporosis, Glostrup Hospital, Copenhagen, Denmark vshanbhogue@health.sdu.dk. 2. Department of EndocrinologyOdense University Hospital, Institute of Clinical Research, University of Southern Denmark, Kloevervaenget 6.1.sal, DK-5000 Odense C, DenmarkDepartments of Diagnostics and Medicine MResearch Center for Ageing and Osteoporosis, Glostrup Hospital, Copenhagen, Denmark.
Abstract
OBJECTIVE AND DESIGN: Patients with type 2 diabetes mellitus (T2D) have an increased fracture risk despite a normal or elevated bone mineral density (BMD). The aim of this cross-sectional in vivo study was to assess parameters of peripheral bone microarchitecture, estimated bone strength and bone remodeling in T2D patients with and without diabetic microvascular disease (MVD+ and MVD- respectively) and to compare them with healthy controls. METHODS: Fifty-one T2D patients (MVD+ group: n=25) were recruited from Funen Diabetic Database and matched for age, sex and height with 51 healthy subjects. High-resolution peripheral quantitative tomography (HR-pQCT) was used to assess bone structure at the non-dominant distal radius and tibia. Estimated bone strength was calculated using finite element analysis. Biochemical markers of bone turnover were measured in all participants. RESULTS: After adjusting for BMI, MVD+ patients displayed lower cortical volumetric BMD (P=0.02) and cortical thickness (P=0.02) and higher cortical porosity at the radius (P=0.02) and a trend towards higher cortical porosity at the tibia (P=0.07) compared to controls. HR-pQCT parameters did not differ between MVD- and control subjects. Biochemical markers of bone turnover were significantly lower in MVD+ and MVD- patients compared to controls (all P<0.01). These were no significant correlations between disease duration, glycemic control (average glycated hemoglobin over the previous 3 years) and HR-pQCT parameters. CONCLUSION: Cortical bone deficits are not a characteristic of all T2D patients but of a subgroup characterized by the presence of microvascular complications. Whether this influences fracture rates in these patients needs further investigation.
OBJECTIVE AND DESIGN:Patients with type 2 diabetes mellitus (T2D) have an increased fracture risk despite a normal or elevated bone mineral density (BMD). The aim of this cross-sectional in vivo study was to assess parameters of peripheral bone microarchitecture, estimated bone strength and bone remodeling in T2D patients with and without diabetic microvascular disease (MVD+ and MVD- respectively) and to compare them with healthy controls. METHODS: Fifty-one T2D patients (MVD+ group: n=25) were recruited from Funen Diabetic Database and matched for age, sex and height with 51 healthy subjects. High-resolution peripheral quantitative tomography (HR-pQCT) was used to assess bone structure at the non-dominant distal radius and tibia. Estimated bone strength was calculated using finite element analysis. Biochemical markers of bone turnover were measured in all participants. RESULTS: After adjusting for BMI, MVD+ patients displayed lower cortical volumetric BMD (P=0.02) and cortical thickness (P=0.02) and higher cortical porosity at the radius (P=0.02) and a trend towards higher cortical porosity at the tibia (P=0.07) compared to controls. HR-pQCT parameters did not differ between MVD- and control subjects. Biochemical markers of bone turnover were significantly lower in MVD+ and MVD- patients compared to controls (all P<0.01). These were no significant correlations between disease duration, glycemic control (average glycated hemoglobin over the previous 3 years) and HR-pQCT parameters. CONCLUSION:Cortical bone deficits are not a characteristic of all T2D patients but of a subgroup characterized by the presence of microvascular complications. Whether this influences fracture rates in these patients needs further investigation.
Authors: Lamya Karim; Julia Moulton; Miranda Van Vliet; Kelsey Velie; Ann Robbins; Fatemeh Malekipour; Ayesha Abdeen; Douglas Ayres; Mary L Bouxsein Journal: Bone Date: 2018-05-30 Impact factor: 4.398
Authors: U Heilmeier; K Cheng; C Pasco; R Parrish; J Nirody; J M Patsch; C A Zhang; G B Joseph; A J Burghardt; A V Schwartz; T M Link; G Kazakia Journal: Osteoporos Int Date: 2016-05-06 Impact factor: 4.507
Authors: Elizabeth J Samelson; Serkalem Demissie; L Adrienne Cupples; Xiaochun Zhang; Hanfei Xu; Ching-Ti Liu; Steven K Boyd; Robert R McLean; Kerry E Broe; Douglas P Kiel; Mary L Bouxsein Journal: J Bone Miner Res Date: 2017-09-20 Impact factor: 6.741
Authors: Jessica F Starr; Leonardo C Bandeira; Sanchita Agarwal; Ankit M Shah; Kyle K Nishiyama; Yizhong Hu; Donald J McMahon; X Edward Guo; Shonni J Silverberg; Mishaela R Rubin Journal: J Bone Miner Res Date: 2018-06-15 Impact factor: 6.741