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Bone density, microstructure deficits found in type 2 diabetes
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Researchers identified deficits in bone microstructure and volumetric bone density at the distal tibia and distal radius in adults with type 2 diabetes, according to findings published in the Journal of Bone and Mineral Research.
Elizabeth J. Samelson, PhD, of the Institute for Aging Research at Hebrew SeniorLife and the department of medicine at Harvard Medical School, and colleagues evaluated data from the Framingham Offspring Cohort on 1,069 adults (606 women; mean age, 64 years; 31% with obesity; 12% with type 2 diabetes) to determine the effect of type 2 diabetes on cortical bone density and cortical microarchitecture. The baseline visit occurred between 2005 and 2008. High-resolution peripheral quantitative CT (HR-pQCT) was performed at the follow-up visit between 2012 and 2015 for a mean follow-up of 7.4 years.
HR-pQCT was used to assess volumetric bone density and bone microarchitecture at the ultradistal tibia and ultradistal radius.
Prior fracture was reported by one-third of participants.
Compared with participants without type 2 diabetes, participants with had lower (P < .01) and higher cortical porosity at the tibia (P = .02). No differences were observed between participants with and without type 2 diabetes for cortical thickness, cortical area fraction and cortical tissue mineral density at the tibia and radius.
Among participants with a prior fracture, those with type 2 diabetes had lower cortical volumetric BMD at the tibia and cortical thickness at the radius compared with those without type 2 diabetes.
Among participants with type 2 diabetes, those with a prior fracture had worse cortical indices, including lower tibia cortical volumetric BMD, lower tibia cortical tissue mineral density and lower radius cortical thickness, compared with those without prior fracture.
Prior fracture was associated with worse trabecular indices, including lower trabecular volumetric BMD, lower trabecular number, higher trabecular separation, lower cortical volumetric BMD and cortical tissue mineral density at the tibia, in participants without type 2 diabetes.
A trend was observed for longer diabetes duration and decreasing tibia cortical density, increasing tibial cortical porosity and increasing tibial trabecular number.
“Given the exponential growth projected for both [type 2 diabetes] and osteoporosis, diabetic bone disease will increasingly become a major clinical and public health problem,” the researchers wrote. “Development of preventive strategies, including effective imaging modalities for screening, is urgently needed because current clinical guidelines do not adequately identify [type 2 diabetes] at risk of fracture.” – by Amber Cox
Disclosures: Samelson reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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