Abstract

PurposeEvidence about bone microarchitecture in Asian type 1 diabetes (T1D) patients is lacking. We assessed the bone microarchitecture in T1D patients versus controls and compare the differences between juvenile-onset and adult-onset T1D patients.MethodsThis cross-sectional study recruited 32 Asian males with T1D and 32 age-, sex-, and body mass index (BMI)-matched controls. Dual-energy X-ray absorptiometry (DXA) and high-resolution peripheral quantitative computed tomography (HR-pQCT) for ultradistal nondominant radius and tibia were performed. The data were analyzed using Student’s t test and analysis of covariance.ResultsAmong the patients, 15 had juvenile-onset T1D, with a median disease duration of 11 years, and 17 had adult-onset T1D, with a median disease duration of 7 years. At the radius, adult-onset and juvenile-onset T1D patients had lower total volumetric bone mineral density (vBMD), trabecular vBMD, trabecular bone volume fraction (BV/TV), and trabecular thickness (Tb.Th) (p < 0.05) than the control subjects. After adjusting for BMI, disease duration, and insulin dose, juvenile-onset patients tended to have lower trabecular vBMD, BV/TV, Tb.Th, and intracortical porosity (Ct.Po) than adult-onset patients. At the tibia, adult-onset patients displayed lower total vBMD, lower Ct. vBMD, and higher Ct.Po (p < 0.05), while juvenile-onset patients had lower Tb.Th and standard deviation of trabecular number (1/Tb.N.SD) (p < 0.05) than control subjects. After adjustment for covariates, adult-onset patients tended to have higher cortical pore diameter (Ct.Po.Dm) than juvenile-onset patients.ConclusionsT1D patients were associated with compromised bone microarchitecture, adult-onset and juvenile-onset T1D patients demonstrated some differences in cortical and trabecular microarchitecture.

Highlights

  • Patients with type 1 diabetes mellitus (T1D) have a substantially increased risk of fractures [1,2,3]

  • A total of 32 adult male T1D patients were recruited for this study; 15 of them had juvenile-onset T1D, and the other 17 had adult-onset T1D

  • We found that males with both adult-onset and juvenile-onset T1D exhibited deficits in volumetric density and microarchitecture when compared with control subjects

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Summary

Introduction

Patients with type 1 diabetes mellitus (T1D) have a substantially increased risk of fractures [1,2,3]. Studies on volumetric BMD (vBMD) assessed using quantitative computed tomography (QCT), peripheral quantitative computed tomography (pQCT), and high-resolution pQCT (HR-pQCT) have shown that T1D patients have lower trabecular or cortical vBMD, or both, than control subjects [14]. These QCTs can be used to evaluate bone geometry and microarchitecture, which are factors considered to be associated with fracture risk [15, 16]

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