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Compromised cortical bone compartment in type 2 diabetes mellitus patients with microvascular disease

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Shanbhogue, Vikram V ; Hansen, Stinus ; Frost, Morten ; Jørgensen, Niklas Rye ; Hermann, Anne Pernille ; Henriksen, Jan Erik ; Brixen, Kim. / Compromised cortical bone compartment in type 2 diabetes mellitus patients with microvascular disease. I: European Journal of Endocrinology. 2016 ; Bind 174, Nr. 2. s. 115-24.

Bibtex

@article{e024f1807a7e410d8b6231effa72554e,
title = "Compromised cortical bone compartment in type 2 diabetes mellitus patients with microvascular disease",
abstract = "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 (MVD+ and MVD- respectively) and to compare them with healthy controls.METHODS: Fifty-one T2D patients (MVD+ 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, MVD+ patients displayed lower cortical volumetric BMD (P=0.02) and cortical thickness (P=0.02) and higher cortical porosity at the radius (P=0.02) and a trend towards higher cortical porosity at the tibia (P=0.07) compared to controls. HR-pQCT parameters did not differ between MVD- and control subjects. Biochemical markers of bone turnover were significantly lower in MVD+ and MVD- patients 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.",
keywords = "Absorptiometry, Photon, Adult, Aged, Biomarkers, Biomechanical Phenomena, Bone Density, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Female, Finite Element Analysis, Humans, Male, Middle Aged, Radius, Tibia, Tomography, X-Ray Computed, Journal Article, Research Support, Non-U.S. Gov't",
author = "Shanbhogue, {Vikram V} and Stinus Hansen and Morten Frost and J{\o}rgensen, {Niklas Rye} and Hermann, {Anne Pernille} and Henriksen, {Jan Erik} and Kim Brixen",
note = "{\circledC} 2016 European Society of Endocrinology.",
year = "2016",
month = "2",
doi = "10.1530/EJE-15-0860",
language = "English",
volume = "174",
pages = "115--24",
journal = "European Journal of Endocrinology",
issn = "0804-4643",
publisher = "BioScientifica Ltd",
number = "2",

}

RIS

TY - JOUR

T1 - Compromised cortical bone compartment in type 2 diabetes mellitus patients with microvascular disease

AU - Shanbhogue, Vikram V

AU - Hansen, Stinus

AU - Frost, Morten

AU - Jørgensen, Niklas Rye

AU - Hermann, Anne Pernille

AU - Henriksen, Jan Erik

AU - Brixen, Kim

N1 - © 2016 European Society of Endocrinology.

PY - 2016/2

Y1 - 2016/2

N2 - 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 (MVD+ and MVD- respectively) and to compare them with healthy controls.METHODS: Fifty-one T2D patients (MVD+ 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, MVD+ patients displayed lower cortical volumetric BMD (P=0.02) and cortical thickness (P=0.02) and higher cortical porosity at the radius (P=0.02) and a trend towards higher cortical porosity at the tibia (P=0.07) compared to controls. HR-pQCT parameters did not differ between MVD- and control subjects. Biochemical markers of bone turnover were significantly lower in MVD+ and MVD- patients 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.

AB - 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 (MVD+ and MVD- respectively) and to compare them with healthy controls.METHODS: Fifty-one T2D patients (MVD+ 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, MVD+ patients displayed lower cortical volumetric BMD (P=0.02) and cortical thickness (P=0.02) and higher cortical porosity at the radius (P=0.02) and a trend towards higher cortical porosity at the tibia (P=0.07) compared to controls. HR-pQCT parameters did not differ between MVD- and control subjects. Biochemical markers of bone turnover were significantly lower in MVD+ and MVD- patients 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.

KW - Absorptiometry, Photon

KW - Adult

KW - Aged

KW - Biomarkers

KW - Biomechanical Phenomena

KW - Bone Density

KW - Cross-Sectional Studies

KW - Diabetes Mellitus, Type 2

KW - Diabetic Angiopathies

KW - Female

KW - Finite Element Analysis

KW - Humans

KW - Male

KW - Middle Aged

KW - Radius

KW - Tibia

KW - Tomography, X-Ray Computed

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1530/EJE-15-0860

DO - 10.1530/EJE-15-0860

M3 - Journal article

VL - 174

SP - 115

EP - 124

JO - European Journal of Endocrinology

JF - European Journal of Endocrinology

SN - 0804-4643

IS - 2

ER -

ID: 49458444