The Center for Health Analytics and Discovery, Eastern Virginia Medical School, Harry Lester Building, 651 Colley Avenue, Room 402, Norfolk, VA, 23507, USA.
Master of Healthcare Delivery Science Program, Eastern Virginia Medical School, Norfolk, VA, 23501, USA.
J Endocrinol Invest. 2018 Sep;41(9):1051-1060. doi: 10.1007/s40618-018-0828-x. Epub 2018 Jan 20.
We examined bone mineral density (BMD) and osteoporosis prevalence in those with type 1 compared to type 2 diabetes derived from a nationally representative sample from the civilian community in the United States.
Data from the National Health and Nutrition Examination Survey (NHANES) for 2005-2006, 2007-2008, 2009-2010, and 2013-2014 were merged to obtain a large sample of diabetics at least 20 years of age with participation in the interview and medical examination. Osteoporosis status was defined by BMD at the total femur, femoral neck, or total lumbar spine. Self-reported diabetics that were prescribed insulin within the first year of diagnosis, are currently taking insulin, and reported no prescriptions for any diabetic pills were classified as type 1. Remaining self-reported diabetics were deemed as having type 2.
A total of 2050 diabetics were included in which 87 (4%) were classified as type 1. Type 1 diabetics were found to have a significantly lower BMD at the total femur and femoral neck, but not at the lumbar spine in the adjusted models. Diabetics with type 1 were 4.7 times more likely to have osteoporosis than those with type 2. There was no significant relationship between diabetes type and BMD or osteoporosis prior to adjustment for confounders.
Although our results show an increased likelihood of osteoporosis among those with type 1 diabetes, future studies including a larger sample from a community population are needed. It may benefit diabetics, especially those with type 1, to initiate osteoporosis screening methods including evaluation of fracture risk, bone quality, and BMD measurements at multiple sites earlier than recommended.
我们研究了来自美国平民社区的全国代表性样本中 1 型与 2 型糖尿病患者的骨密度（BMD）和骨质疏松症患病率。
将 2005-2006 年、2007-2008 年、2009-2010 年和 2013-2014 年的国家健康和营养检查调查（NHANES）的数据合并，以获得至少 20 岁、参加访谈和体检的大量糖尿病患者样本。骨质疏松症的状态通过全股骨、股骨颈或全腰椎的 BMD 来定义。自我报告的糖尿病患者在诊断后的第一年被处方胰岛素、目前正在服用胰岛素且报告没有任何糖尿病药物处方的患者被归类为 1 型。其余自我报告的糖尿病患者被认为患有 2 型。
共有 2050 名糖尿病患者被纳入研究，其中 87 名（4%）被归类为 1 型。在调整后的模型中，1 型糖尿病患者的全股骨和股骨颈的 BMD 明显较低，但腰椎的 BMD 则没有。在调整混杂因素之前，1 型糖尿病患者发生骨质疏松症的可能性是 2 型糖尿病患者的 4.7 倍。糖尿病类型与 BMD 或骨质疏松症之间没有显著关系。
尽管我们的结果显示 1 型糖尿病患者发生骨质疏松症的可能性增加，但仍需要包括来自社区人群的更大样本的未来研究。对于糖尿病患者，尤其是 1 型糖尿病患者，可能需要更早地启动骨质疏松症筛查方法，包括评估骨折风险、骨质量和多处 BMD 测量，这比推荐的方法更早。
