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成年起病与青少年起病 1 型糖尿病亚洲男性与非糖尿病男性骨微观结构差异的比较:一项观察性横断面初步研究。

Comparison of differences in bone microarchitecture in adult- versus juvenile-onset type 1 diabetes Asian males versus non-diabetes males: an observational cross-sectional pilot study.

机构信息

Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science, 100730, Beijing, China.

Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, 100005, Beijing, China.

出版信息

Endocrine. 2021 Jan;71(1):87-95. doi: 10.1007/s12020-020-02480-5. Epub 2020 Sep 11.

Abstract

PURPOSE

Evidence 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.

METHODS

This 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.

RESULTS

Among 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.

CONCLUSIONS

T1D patients were associated with compromised bone microarchitecture, adult-onset and juvenile-onset T1D patients demonstrated some differences in cortical and trabecular microarchitecture.

摘要

目的

亚洲 1 型糖尿病(T1D)患者的骨微观结构证据不足。我们评估了 T1D 患者与对照组之间的骨微观结构,并比较了青少年发病和成年发病 T1D 患者之间的差异。

方法

这项横断面研究招募了 32 名亚洲男性 T1D 患者和 32 名年龄、性别和体重指数(BMI)匹配的对照组。对非优势桡骨和胫骨进行双能 X 射线吸收法(DXA)和高分辨率外周定量计算机断层扫描(HR-pQCT)。使用学生 t 检验和协方差分析对数据进行分析。

结果

在患者中,15 名患有青少年发病 T1D,中位病程为 11 年,17 名患有成年发病 T1D,中位病程为 7 年。在桡骨中,成年发病和青少年发病 T1D 患者的总容积骨矿物质密度(vBMD)、小梁 vBMD、小梁骨体积分数(BV/TV)和小梁厚度(Tb.Th)均低于对照组(p<0.05)。在校正 BMI、病程和胰岛素剂量后,青少年发病患者的小梁 vBMD、BV/TV、Tb.Th 和皮质内孔隙率(Ct.Po)趋于低于成年发病患者。在胫骨中,成年发病患者的总 vBMD、较低的 Ct.vBMD 和较高的 Ct.Po(p<0.05),而青少年发病患者的 Tb.Th 和小梁数的标准差(1/Tb.N.SD)(p<0.05)低于对照组。在校正协变量后,成年发病患者的皮质孔直径(Ct.Po.Dm)趋于高于青少年发病患者。

结论

T1D 患者的骨微观结构受损,青少年发病和成年发病 T1D 患者的皮质和小梁微观结构存在一些差异。

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