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Type 1 diabetes tied to decreased areal, trabecular volumetric BMD

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May 31, 2017

Adults with type 1 diabetes had decreased areal bone mineral density, trabecular volumetric bone mineral density and cortical bone size compared with adults without diabetes, according to findings published in The Journal of Clinical Endocrinology & Metabolism.

Charlotte Verroken, MD, of the unit for osteoporosis and metabolic bone disease, department of endocrinology at Ghent University Hospital in Belgium, and colleagues evaluated 64 adults with type 1 diabetes (mean age, 41.1 years; 38 men) and 63 sex- and age-matched controls to compare areal and volumetric bone parameters and cortical bone geometry among them.

DXA was used to evaluate areal bone parameters and peripheral quantitative CT was used to evaluate volumetric bone parameters and cortical bone geometry.

Lower bone mineral content and areal BMD at the total body (P < .001), femoral neck (P = .001) and total hip (P = .006) were found among participants with type 1 diabetes compared with participants without type 1 diabetes. A 0.9% smaller bone area at the total body was associated with type 1 diabetes.

Participants with type 1 diabetes had 10.4% larger trabecular area at the distal radius, 8.8% lower trabecular volumetric BMD at the distal radius, 2.1% higher cortical volumetric BMD at the radial shaft, 5% lower total volumetric BMD at the radial shaft, 6.1% larger endosteal circumference, 5.6% smaller cortical thickness and 6% lower cortical/total bone area ratio compared with controls.

“This study showed that in addition to the known deficits in [areal] BMD and trabecular [volumetric] BMD, adults patients with [type 1 diabetes] present with a cortical bone size deficit, specifically characterized by a similar periosteal but larger endosteal circumference as compared to nondiabetic subjects,” the researchers wrote. “These differences in bone geometry cannot be explained by differences in body composition or bone turnover, but may be associated with glycemic variability as well as with a higher bone marrow fat content in subjects with [type 1 diabetes]. Given the important contribution of bone geometry to overall fracture risk, we hypothesize that the cortical bone size deficit may contribute to the increased fracture risk associated with [type 1 diabetes].” – by Amber Cox

Disclosure: The researchers report no relevant financial disclosures.

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