Bone and Muscle Research Group & Faculty of Applied Sciences, Ton Duc Thang University, 19 Nguyen Huu Tho, Tan Phong, District 7, Ho Chi Minh City, 700000, Vietnam.
School of Biomedical Engineering, University of Technology Sydney (UTS), Sydney, Australia.
Osteoporos Int. 2018 Sep;29(9):2059-2067. doi: 10.1007/s00198-018-4579-5. Epub 2018 Jul 2.
It is not clear why type 2 diabetes (T2D) has an increased risk of fracture despite higher areal bone mineral density. This study showed that compared with controls, T2D patients had higher trabecular bone density but lower cortical bone density, resulting in a lower bone strength.
To define the association between type 2 diabetes and bone architecture and measures of bone strength.
The study was part of the Vietnam Osteoporosis Study, in which 1115 women and 614 men aged ≥ 30 were randomly recruited from Ho Chi Minh City. HbA levels were measured with analyzers ADAMS™ A HA-8160 (Arkray, Kyoto, Japan). The diagnosis of T2D was made if HbA1c was ≥ 6.5%. Trabecular and cortical volumetric bone density (vBMD) was measured in the forearm and leg by a pQCT XCT2000 (Stratec, Germany). Polar stress strain index (pSSI) was derived from the pQCT measurements. Difference in bone parameters between T2D and non-diabetic individuals was assessed by the number of standard deviations (effect size [ES]) by the propensity score analysis.
The prevalence of T2D was ~ 8%. The results of propensity score matching for age, sex, and body mass index in 137 pairs of diabetic and non-diabetic individuals showed that T2D patients had significantly higher distal radius trabecular vBMD (ES 0.26; 95% CI, 0.02 to 0.50), but lower cortical vBMD (ES - 0.22; - 0.46 to 0.00) and reduced pSSI (ES - 0.23; - 0.47 to - 0.02) compared with non-diabetic individuals. Multiple linear regression analysis based on the entire sample confirmed the results of the propensity score analysis.
Compared with non-diabetic individuals, patients with T2D have greater trabecular but lower cortical vBMD which leads to lower bone strength.
定义 2 型糖尿病与骨结构和骨强度测量之间的关系。
该研究是越南骨质疏松症研究的一部分，其中 1115 名女性和 614 名年龄≥30 岁的男性从胡志明市随机招募。使用 ADAMS™ A HA-8160 分析仪（Arkray，京都，日本）测量 HbA 水平。如果 HbA1c≥6.5%，则诊断为 2 型糖尿病。前臂和腿部的骨小梁和皮质体积骨密度（vBMD）通过 pQCT XCT2000（Stratec，德国）进行测量。从 pQCT 测量中得出极向应变指数（pSSI）。通过倾向评分分析，通过标准偏差数（效应大小[ES]）评估糖尿病和非糖尿病个体之间骨参数的差异。
2 型糖尿病的患病率约为 8%。在 137 对糖尿病和非糖尿病个体的年龄、性别和体重指数的倾向评分匹配后，结果显示，与非糖尿病个体相比，2 型糖尿病患者的桡骨远端小梁 vBMD 显著更高（ES 0.26；95%CI，0.02 至 0.50），但皮质 vBMD 更低（ES-0.22；-0.46 至 0.00），pSSI 降低（ES-0.23；-0.47 至-0.02）。基于整个样本的多元线性回归分析证实了倾向评分分析的结果。
与非糖尿病个体相比，2 型糖尿病患者的骨小梁更大，但皮质骨密度更低，导致骨强度降低。
