与单纯骨关节炎对照者相比，2 型糖尿病合并骨关节炎的成年人的骨矿化水平升高，且异质性降低。
Bone mineralization is elevated and less heterogeneous in adults with type 2 diabetes and osteoarthritis compared to controls with osteoarthritis alone.
机构信息
Faculty of Health Sciences, McMaster University, 1280 Main St West, Hamilton ON, Canada L8S 4K1.
出版信息
Bone. 2013 May;54(1):76-82. doi: 10.1016/j.bone.2013.01.032. Epub 2013 Jan 26.
PURPOSE
The purpose of this study was to determine whether trabecular bone mineralization differed in adults with type 2 diabetes compared to adults without type 2 diabetes.
METHODS
Proximal femur specimens were obtained following a total hip replacement procedure from men and women ≥65 years of age with and without type 2 diabetes. A scanning electron microscope was used for quantitative backscattered electron imaging (qBEI) analysis of trabecular bone samples from the femoral neck. Gray scale images (pixel size=5.6 μm(2)) were uploaded to ImageJ software and gray level (GL) values were converted to calcium concentrations (weight [wt] % calcium [Ca]) using data obtained with energy dispersive X-ray spectrometry. The following bone mineralization density distribution (BMDD) outcomes were collected: the weighted mean bone calcium concentration (CaMEAN), the most frequently occurring bone calcium concentration (CaPEAK) and mineralization heterogeneity (CaWIDTH). Differences between groups were assessed using the Student's t-test for normally distributed data and Mann-Whitney U-test for non-normally distributed data. An alpha value of <0.05 was considered significant.
RESULTS
Thirty-five Caucasian participants were recruited (mean [standard deviation, SD] age, 75.5 [6.5]years): 14 adults with type 2 diabetes (years since type 2 diabetes diagnosis, 13.5 [7.4]years) and 21 adults without type 2 diabetes. In the adults with type 2 diabetes, bone CaMEAN was 4.9% greater (20.36 [0.98]wt.% Ca versus 19.40 [1.07]wt.% Ca, p=0.015) and CaWIDTH was 9.4% lower (median [interquartile range] 3.55 [2.99-4.12]wt.% Ca versus 3.95 [0.71]wt.% Ca, p<0.001) compared to controls. There was no between-group difference in CaPEAK (21.12 [0.97]wt.% Ca for type 2 diabetes versus 20.44 [1.30]wt.% Ca for controls, p=0.121).
CONCLUSION
The combination of elevated mean calcium concentration in bone and lower mineralization heterogeneity in adults with type 2 diabetes may have deleterious effects on the biomechanical properties of bone. These microscopic alterations in bone mineralization, which may be mediated by suppressed bone remodeling, further elucidate higher fracture risk in adults with type 2 diabetes.
目的
本研究旨在确定 2 型糖尿病患者与非 2 型糖尿病患者的骨小梁矿化是否存在差异。
方法
从年龄在 65 岁及以上的男性和女性的全髋关节置换术中获得股骨近端标本，这些患者患有或未患有 2 型糖尿病。使用扫描电子显微镜对股骨颈骨小梁样本进行定量背散射电子成像（qBEI）分析。将灰度图像（像素大小=5.6 μm(2)）上传到 ImageJ 软件中，并使用能量色散 X 射线光谱法获得的数据将灰度值（GL）转换为钙浓度（wt%钙[Ca]）。收集以下骨矿化密度分布（BMDD）结果：加权平均骨钙浓度（CaMEAN）、最常见的骨钙浓度（CaPEAK）和矿化异质性（CaWIDTH）。使用正态分布数据的学生 t 检验和非正态分布数据的曼-惠特尼 U 检验评估组间差异。α 值<0.05 被认为具有统计学意义。
结果
共招募了 35 名白种人参与者（平均[标准差，SD]年龄，75.5[6.5]岁）：14 名患有 2 型糖尿病的成年人（2 型糖尿病诊断后的年数，13.5[7.4]年）和 21 名无 2 型糖尿病的成年人。在患有 2 型糖尿病的成年人中，骨 CaMEAN 增加了 4.9%（20.36[0.98]wt.% Ca 与 19.40[1.07]wt.% Ca，p=0.015），CaWIDTH 降低了 9.4%（中位数[四分位间距]3.55[2.99-4.12]wt.% Ca 与 3.95[0.71]wt.% Ca，p<0.001）。与对照组相比，两组间 CaPEAK 无差异（21.12[0.97]wt.% Ca 用于 2 型糖尿病，20.44[1.30]wt.% Ca 用于对照组，p=0.121）。
结论
2 型糖尿病患者骨中平均钙浓度升高和矿化异质性降低的组合可能对骨的生物力学特性产生有害影响。这些骨矿化的微观变化可能是由骨重塑抑制介导的，进一步阐明了 2 型糖尿病患者骨折风险增加的原因。
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