Bone and Vascular Health in Postmenopausal Women with Type 1 Diabetes

Abstract

The risk for cardiovascular (CV) disease and osteoporotic fractures is higher in postmenopausal women with type 1 diabetes (T1D). However, it is unclear whether these processes have common risk factors. We examined the associations between bone mineral density (BMD), trabecular bone score (TBS), and CV risk measures in 47 postmenopausal women with T1D (62 years, diabetes duration; 41 years and A1c 7.8%) and 51 postmenopausal women without diabetes (64 years and A1c 5.5%). Age, menopausal duration, BMI, serum creatinine, calcium, 25-OH-D, parathyroid hormone (PTH) and bone turnover markers (BTMs) were similar between two groups. T1D postmenopausal women had lower left femoral neck and distal forearm BMD, and subendocardial viability index (SVI) and higher augmented pressure (AP) and carotid intima media thickness (cIMT) compared to controls (Table). HbA1c was negatively correlated with distal forearm BMD, TBS and SVI and positively correlated with AP. Total cholesterol and LDL-C were associated with arterial stiffness but not with BMD. PTH and BTMs were associated with lower BMD but not with CV risk measures. Urinary microalbumin was inversely correlated with distal forearm BMD and TBS, and positively correlated with AP and cIMT. T1D is associated with lower femoral neck and distal forearm BMD and higher arterial stiffness and cIMT. Urine microalbumin was the only factor linked to both low BMD and high CV risk.VariablesPostmenopausal women with T1D (n=47)Postmenopausal women without diabetes (n=51)P-valueLeft femoral neck BMD (g/cm2)0.6±0.10.7±0.10.01Left distal forearm BMD (g/cm2)0.61±0.090.66±0.080.008Lumbar spine BMD(g/cm2)0.9±0.10.9±0.10.9Subendocardial viability index (%)119.0±18.1149.1±23.9<0.001Augmented pressure (mmHG)16.4±6.013.3±5.10.006Carotid intima media thickness (mm)0.7±0.10.6±0.090.01 Disclosure V.N. Shah: None. P. Joshee: None. R.M. Sippl: None. J.K. Snell-Bergeon: Stock/Shareholder; Self; Abbott. Research Support; Self; Roche Diagnostics Corporation.