Shanbhogue V.V.,University of Southern Denmark |
Hansen S.,University of Southern Denmark |
Frost M.,University of Southern Denmark |
Jorgensen N.R.,Research Center for Ageing and Osteoporosis |
And 3 more authors.
European Journal of Endocrinology | Year: 2016
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 (MVDC and MVDK respectively) and to compare them with healthy controls. Methods: Fifty-one T2D patients (MVDC 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, MVDC patients displayed lower cortical volumetric BMD (PZ0.02) and cortical thickness (PZ0.02) and higher cortical porosity at the radius (PZ0.02) and a trend towards higher cortical porosity at the tibia (PZ0.07) compared to controls. HR-pQCT parameters did not differ between MVDKand control subjects. Biochemical markers of bone turnover were significantly lower in MVDCand MVDKpatients 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. © 2016 The authors Published by Bioscientifica Ltd.