Article, 2023

Bone parameters in T1D and T2D assessed by DXA and HR-pQCT – A cross-sectional study: The DIAFALL study

Bone, ISSN 8756-3282, 1873-2763, Volume 172, Page 116753, 10.1016/j.bone.2023.116753

Contributors

Rasmussen, Nicklas Højgaard-Hessellund 0000-0002-3880-3058 (Corresponding author) [1] Dal, Jakob [1] Kvist, Annika Vestergaard 0000-0002-4291-544X [1] [2] [3] [4] Van Den Bergh, Joop P W 0000-0003-3984-2232 [5] [6] [7] Jensen, Morten Hasselstrøm 0000-0002-6649-8644 [8] Vestergaard, Peter 0000-0002-9046-2967 [1]

Affiliations

  1. [1] Aalborg University Hospital
    2. [NORA names: North Denmark Region; Hospital; Denmark; Europe, EU; Nordic; OECD];
  2. [2] ETH Zurich
    3. [NORA names: Switzerland; Europe, Non-EU; OECD];
  3. [3] Odense University Hospital
    4. [NORA names: Region of Southern Denmark; Hospital; Denmark; Europe, EU; Nordic; OECD];
  4. [4] University of Southern Denmark
    5. [NORA names: SDU University of Southern Denmark; University; Denmark; Europe, EU; Nordic; OECD];
  5. [5] Maastricht University
    6. [NORA names: Netherlands; Europe, EU; OECD];

Abstract

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

BMD, BMI, DXA, DXA scans, HR-pQCT, HR-pQCT scans, HbA1c, T1D, T2D, a cross-sectional study, adjustment, adult participants, age, alcohol, alcohol use, area, areal bone mineral density, areal bone mineral density measurements, biochemistry, bone, bone microarchitecture, bone mineral density, bone parameters, bone stiffness, bone strength parameters, compare areal bone mineral density, comparison, control, cortical areas, cortical volumetric BMD, cross-sectional study, decreased aBMD, density, diabetes, diabetes duration, duration, failure, failure load, favorable bone microarchitecture, femoral neck, fracture, fragility, group, group comparisons, handgrip, handgrip strength, high stiffness, higher volumetric BMD, history, increased risk, load, low separation, lower trabecular separation, measurements, medical history, microarchitecture, mineral density, neck, number, parameters, participants, people, perception threshold, peripheral sites, questionnaire, radius, scanning, separation, sex, sites, skeletal fragility, smoking, stiffness, strength, strength parameters, study, thickness, threshold, tibia, timed up-and-go, trabecular, trabecular measures, trabecular number, trabecular separation, trabecular volumetric BMD, type, type 1 diabetes, type 2 diabetes, use, vibration, vibration perception threshold, volumetric BMD

Funders

  • Novo Nordisk (Denmark)

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