血糖正常和血糖升高的黑人和白人老年人的骨材料强度。
Bone material strength in normoglycemic and hyperglycemic black and white older adults.
机构信息
Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA.
Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, USA.
出版信息
Osteoporos Int. 2019 Dec;30(12):2429-2435. doi: 10.1007/s00198-019-05140-1. Epub 2019 Aug 28.
UNLABELLED
This cross-sectional study assessed cortical bone properties via impact microindentation in adults with normoglycemia, prediabetes, and early-stage T2D. Bone material strength index was stable across the glycemia categories in whites but it declined in blacks. Blacks may be more susceptible than whites to impaired cortical bone properties in early diabetes.
INTRODUCTION
Individuals with long-standing type 2 diabetes (T2D) have altered cortical bone material properties as determined by impact microindentation. This cross-sectional study was done to determine whether altered cortical bone material properties could be detected in adults with prediabetes or early-stage T2D.
METHODS
Men and postmenopausal women aged ≥ 50 years with no diabetes (50 white, 6 black), prediabetes (75 white, 13 black), and T2D of ≤ 5 years duration (24 white and 16 black) had assessments of bone material strength index (BMSi) by impact microindentation, trabecular bone score (TBS), and bone mineral density (BMD) by DXA and the advanced glycation end product, urine pentosidine.
RESULTS
The association between glycemia category and BMSi differed by race (interaction p = 0.037). In the whites, BMSi did not differ across the glycemia categories, after adjustment for age, sex, and BMI (no diabetes 76.3 ± 1.6 (SEM), prediabetes 77.2 ± 1.3, T2D 76.2 ± 2.5, ANCOVA p = 0.887). In contrast, in the blacks, BMSi differed (ANCOVA p = 0.020) and was significantly lower in subjects with T2D than in those with prediabetes (p < 0.05) and no diabetes (p < 0.05) (mean ± SEM BMSi in no diabetes 86.0 ± 4.3, prediabetes 91.0 ± 3.2, and T2D 71.6 ± 2.9). Neither TBS nor urine pentosidine differed significantly across the glycemia categories in either whites or blacks.
CONCLUSIONS
These findings suggest different associations of glycemia with cortical bone material properties in blacks and whites, with blacks possibly being more susceptible to impaired cortical bone properties than whites in early diabetes. A larger study is needed to verify these observations.
目的
本横断面研究通过冲击微压痕评估了血糖正常、前驱糖尿病和 2 型糖尿病早期患者的皮质骨特性。在白种人中，骨材料强度指数在血糖分类中保持稳定，但在黑种人中下降。黑人可能比白人更容易在早期糖尿病中出现皮质骨特性受损。
方法
年龄≥50 岁的无糖尿病（50 名白种人，6 名黑人）、前驱糖尿病（75 名白种人，13 名黑人）和病程≤5 年的 2 型糖尿病患者（24 名白种人和 16 名黑人）接受了冲击微压痕、骨小梁评分（TBS）和双能 X 线吸收法（DXA）测量的骨矿物质密度（BMD）以及尿戊糖的评估。
结果
血糖类别与 BMSi 的相关性因种族而异（交互 p=0.037）。在白种人中，调整年龄、性别和 BMI 后，BMSi 在血糖分类中没有差异（无糖尿病 76.3±1.6（SEM），前驱糖尿病 77.2±1.3，2 型糖尿病 76.2±2.5，ANCOVA p=0.887）。相比之下，在黑人中，BMSi 存在差异（ANCOVA p=0.020），2 型糖尿病患者的 BMSi 明显低于前驱糖尿病患者（p<0.05）和无糖尿病患者（p<0.05）（无糖尿病患者的平均±SEM BMSi 为 86.0±4.3，前驱糖尿病患者为 91.0±3.2，2 型糖尿病患者为 71.6±2.9）。在白种人和黑人中，TBS 和尿戊糖均未在血糖分类中显著差异。
结论
这些发现表明，在白种人和黑人中，血糖与皮质骨材料特性的关联不同，黑人在早期糖尿病中皮质骨特性受损的可能性可能比白人更高。需要更大的研究来验证这些观察结果。
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