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Bone Geometry, Volumetric Density, Microarchitecture, and Estimated Bone Strength Assessed by HR-pQCT in Adult Patients With Type 1 Diabetes Mellitus
Open accessAbstract
The primary goal of this cross-sectional in vivo study was to assess peripheral bone microarchitecture, bone strength, and bone remodeling in adult type 1 diabetes (T1D) patients with and without diabetic microvascular disease (MVD+ and MVD–, respectively) and to compare them with age-, gender-, and height-matched healthy control subjects (CoMVD+ and CoMVD–, respectively). The secondary goal was to assess differences in MVD– and MVD+ patients. Fifty-five patients with T1DM (MVD+ group: n = 29) were recruited from the Funen Diabetes Database. Dual-energy X-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HR-pQCT) of the ultradistal radius and tibia, and biochemical markers of bone turnover were performed in all participants. There were no significant differences in HR-pQCT parameters between MVD– and CoMVD– subjects. In contrast, MVD+ patients had larger total and trabecular bone areas (p = 0.04 and p = 0.02, respectively), lower total, trabecular, and cortical volumetric bone mineral density (vBMD) (p < 0.01, p < 0.04, and p < 0.02, respectively), and thinner cortex (p = 0.03) at the radius, and lower total and trabecular vBMD (p = 0.01 and p = 0.02, respectively) at the tibia in comparison to CoMVD+. MVD+ patients also exhibited lower total and trabecular vBMD (radius p = 0.01, tibia p < 0.01), trabecular thickness (radius p = 0.01), estimated bone strength, and greater trabecular separation (radius p = 0.01, tibia p < 0.01) and network inhomogeneity (radius p = 0.01, tibia p < 0.01) in comparison to MVD– patients. These differences remained significant after adjustment for age, body mass index, gender, disease duration, and glycemic control (average glycated hemoglobin over the previous 3 years). Although biochemical markers of bone turnover were significantly lower in MVD+ and MVD– groups in comparison to controls, they were similar between the MVD+ and MVD– groups. The results of our study suggest that the presence of MVD was associated with deficits in cortical and trabecular bone vBMD and microarchitecture that could partly explain the excess skeletal fragility observed in these patients. © 2015 American Society for Bone and Mineral Research.
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Metadata
- Authors
- Shanbhogue, V. V., Hansen, S., Frost, M., Jørgensen, N. R., Hermann, A. P., Henriksen, J. E., & Brixen, K.
- Affiliations
- University of Southern Denmark (DK)
- Corresponding author
- Shanbhogue, Vikram V
- ORCID
- Venue
- Journal of Bone and Mineral Research
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-06-10
- Volume
- 30
- Issue
- 12
- Pages
- 2188-2199
- ISSN
- 0884-0431 (ISSN-L)
- 1523-4681
- OpenAlex
- W2109729276
- Cited by
- 183
- References
- 45
- Citations by year
- 2026: 6 · 2025: 16 · 2024: 15 · 2023: 17 · 2022: 18 · 2021: 15 · 2020: 17 · 2019: 21 · 2018: 23 · 2017: 22 · 2016: 11 · 2015: 2
- FWCI
- 19.90
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Journal of Bone and Mineral Research (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion, other-oa)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- This work was supported by grants from The Research Foundation, Odense University Hospital. MN was supported by a grant from the Danish Council for Independent Research.
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Health Sciences › Medicine › Infectious Diseases › HIV-related health complications and treatments
- Keywords
- type 1 diabetes, diabetic microangiopathy, bone microarchitecture, bone mineral density, bone strength, bone remodeling, bone turnover markers, trabecular bone, cortical bone, bone geometry, ultradistal radius, tibia, trabecular separation, trabecular thickness, network heterogeneity, glycemic control
- MeSH terms
- Adolescent, Adult, Anthropometry, Bone and Bones, Child, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Female, Humans, Male, Microcirculation, Middle Aged, Radius, Tibia, Tomography, X-Ray Computed, Vascular Diseases, Absorptiometry, Photon, Bone Density, Body Mass Index, Case-Control Studies, Bone Remodeling, Young Adult
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