Bone parameters in T1D and T2D assessed by DXA and hr-pQCT – a cross-sectional study:​ the DIAFALL study

Rasmussen, Nicklas Højgaard-hessellund<sup>1,2</sup>; Dal, Jakob<sup>2</sup>; Kvist, Annika Vestergaard<sup>1,3,4,5</sup>; van den Bergh, Joop P.<sup>6,7,8</sup>; Jensen, Morten Hasselstrøm<sup>9</sup>; Vestergaard, Peter<sup>1,2</sup>

Affiliations

¹Steno Diabetes Center North Denmark, Aalborg University Hospital, Denmark

²Department of Endocrinology, Aalborg University Hospital, Denmark

³Department of Endocrinology and Metabolism, Molecular Endocrinology & Stem Cell Research Unit (KMEB) Odense University Hospital, Odense, Denmark

⁴University of Southern Denmark, Odense, Denmark

⁵Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH-Zurich, Zurich, Switzerland

⁶School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands

⁷Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center+, Maastricht, the Netherlands

⁸Department of Internal Medicine, VieCuri Medical Center, Venlo, the Netherlands

⁹Department of Health Science and Technology, Aalborg University, Denmark

Abstract and keywords

Introduction/aim: People with type 1 diabetes (T1D) and type 2 diabetes (T2D) have an increased risk of fractures due to skeletal fragility. We aimed to compare areal bone mineral density (aBMD), volumetric BMD (vBMD), cortical and trabecular measures, and bone strength parameters in participants with diabetes vs. controls.

Methods: In a cross-sectional study, we included adult participants with T1D (n = 111, MA = 52.9 years), T2D (n = 106, MA = 62.1 years) and controls (n = 328, MA = 57.7 years). The study comprised of DXA scans and HR-pQCT scans, biochemistry, handgrip strength (HGS), Timed Up and GO (TUG), vibration perception threshold (VPT), questionnaires, medical histories, alcohol use, and previous fractures. Group comparisons were performed after adjustment for sex, age, BMI, diabetes duration, HbA1c, alcohol, smoking, previous fractures, postmenopausal, HGS, TUG, and VPT.

Results: We found decreased aBMD in participants with T1D at the femoral neck (p = 0.028), whereas T2D had significantly higher aBMD at peripheral sites (legs, arms, p < 0.01) vs. controls. In T1D we found higher vBMD (p < 0.001), cortical vBMD (p < 0.001), cortical area (p = 0.002) and thickness (p < 0.001), lower cortical porosity(p = 0.008), higher stiffness (p = 0.002) and failure load (p = 0.003) at radius and higher vBMD (p = 0.003), cortical vBMD(p < 0.001), bone stiffness (p = 0.023) and failure load(p = 0.044) at the tibia than controls. In T2D we found higher vBMD (p < 0.001), cortical vBMD (p < 0.001), trabecular vBMD (p < 0.001), cortical area (p < 0.001) and thickness (p < 0.001), trabecular number (p = 0.024), lower separation (p = 0.010), higher stiffness (p < 0.001) and failure load (p < 0.001) at the radius and higher total vBMD (p < 0.001), cortical vBMD (p < 0.011), trabecular vBMD (p = 0.001), cortical area (p = 0.002) and thickness (p = 0.021), lower trabecular separation (p = 0.039), higher stiffness (p < 0.001) and failure load (p = 0.034) at tibia compared with controls.

Conclusion: aBMD measures were as expected lower in T1D and higher in T2D than controls. Favorable bone microarchitecture and strength parameters were seen at the tibia and radius for T1D and T2D.

Keywords: Type 1 diabetes; Type 2 diabetes; DXA scan; HR-pQCT; Bone microarchitecture

Links

DOI: 10.1016/j.bone.2023.116753

PubMed: 37001628

WoS: 000989116800001

History

Received: 2023-01-4

Revised: 2023-03-12

Accepted: 2023-03-27

Online: 2023-03-29

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