Abstract
The effects of type 2 diabetes mellitus (T2DM) on bone volumetric density, bone geometry, and estimates of bone strength are not well established. We used peripheral quantitative computed tomography (pQCT) to compare tibial and radial bone volumetric density (vBMD, mg/cm3), total (ToA, mm2) and cortical (CoA, mm2) bone area and estimates of bone compressive and bending strength in a subset (n = 1171) of men (≥65 years of age) who participated in the multisite Osteoporotic Fractures in Men (MrOS) study. Analysis of covariance–adjusted bone data for clinic site, age, and limb length (model 1) and further adjusted for body weight (model 2) were used to compare data between participants with (n = 190) and without (n = 981) T2DM. At both the distal tibia and radius, patients with T2DM had greater bone vBMD (+2% to +4%, model 1, p < .05) and a smaller bone area (ToA −1% to −4%, model 2, p < .05). The higher vBMD compensated for lower bone area, resulting in no differences in estimated compressive bone strength at the distal trabecular bone regions. At the mostly cortical bone midshaft sites of the radius and tibia, men with T2DM had lower ToA (−1% to −3%, p < .05), resulting in lower bone bending strength at both sites after adjusting for body weight (−2% to −5%, p < .05) despite the lack of difference in cortical vBMD at these sites. These data demonstrate that older men with T2DM have bone strength that is low relative to body weight at the cortical-rich midshaft of the radius despite no difference in cortical vBMD. © 2010 American Society for Bone and Mineral Research
Highlights
Observational cohort studies have found that type 2 diabetes mellitus (T2DM) is associated with a 50% to 80% increased risk of hip fracture, as well as a 30% to 70% increased risk of fracture of the proximal humerus and foot.[1,2,3] there is awareness of the higher fracture rates among diabetic adults,(4,5) there are few data available on the factors responsible for this increased risk
But not all, cross-sectional studies have found average or even somewhat higher areal bone mineral density assessed by dual x-ray absorptiometry (DXA) in patients with T2DM compared with healthy controls, even after accounting for larger body size among diabetics.[7,8,9] These results are somewhat surprising given the increased fracture risk associated with T2DM
From March 2000 through April 2002, 5995 men who were at least 65 years of age were enrolled in the baseline examination of the prospective Osteoporotic Fractures in Men (MrOS) study.[19]. Men were recruited from population-based listings in six areas of the United States: Birmingham, Alabama, Minneapolis, Minnesota, Palo Alto, California, the Monongahela Valley near Pittsburgh, Pennsylvania, Portland, Oregon, and San Diego, California.[19,20] Men with a history of bilateral hip replacement and men who were unable to walk without the assistance of another person were excluded
Summary
Observational cohort studies have found that type 2 diabetes mellitus (T2DM) is associated with a 50% to 80% increased risk of hip fracture, as well as a 30% to 70% increased risk of fracture of the proximal humerus and foot.[1,2,3] there is awareness of the higher fracture rates among diabetic adults,(4,5) there are few data available on the factors responsible for this increased risk. Identifying these factors is a critical step in the development of potential interventions to prevent fractures among the growing segment[6] of the adult population with T2DM. This may be important in adults with T2DM for two reasons: [1] trabecular bone, which is disproportionately affected by T2DM,(10) may not be detected by DXA, and [2] bone strength can be reduced even
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
