Syversen Unni, Mosti Mats Peder, Mynarek Ida Maria, Vedal Trude Seselie Jahr, Aasarød Kristin, Basso Trude, Reseland Janne E, Thorsby Per Medbøe, Asvold Bjorn O, Eriksen Erik Fink, Stunes Astrid Kamilla
Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Department of Endocrinology, Trondheim University Hospital (St Olavs Hospital), Trondheim, Norway.
Endocr Connect. 2021 Aug 13;10(8):955-964. doi: 10.1530/EC-21-0193.
Type 1 diabetes (T1D) is associated with substantial fracture risk. Bone mineral density (BMD) is, however, only modestly reduced, suggesting impaired bone microarchitecture and/or bone material properties. Yet, the skeletal abnormalities have not been uncovered. Men with T1D seem to experience a more pronounced bone loss than their female counterparts. Hence, we aimed to examine different aspects of bone quality in men with T1D.
In this cross-sectional study, men with T1D and healthy male controls were enrolled. BMD (femoral neck, total hip, lumbar spine, whole body) and spine trabecular bone score (TBS) were measured by dual x-ray absorptiometry, and bone material strength index (BMSi) was measured by in vivo impact microindentation. HbA1c and bone turnover markers were analyzed.
Altogether, 33 men with T1D (43 ± 12 years) and 28 healthy male controls (42 ± 12 years) were included. Subjects with T1D exhibited lower whole-body BMD than controls (P = 0.04). TBS and BMSi were attenuated in men with T1D vs controls (P = 0.016 and P = 0.004, respectively), and T1D subjects also had a lower bone turnover. The bone parameters did not differ between subjects with or without diabetic complications. Duration of disease correlated negatively with femoral neck BMD but not with TBS or BMSi.
This study revealed compromised bone material strength and microarchitecture in men with T1D. Moreover, our data confirm previous studies which found a modest decrease in BMD and low bone turnover in subjects with T1D. Accordingly, bone should be recognized as a target of diabetic complications.
1型糖尿病（T1D）与较高的骨折风险相关。然而，骨矿物质密度（BMD）仅略有降低，提示骨微结构和/或骨材料特性受损。不过，骨骼异常尚未被发现。患有T1D的男性似乎比女性经历更明显的骨质流失。因此，我们旨在研究患有T1D的男性的骨质量的不同方面。
在这项横断面研究中，纳入了患有T1D的男性和健康男性对照。通过双能X线吸收法测量BMD（股骨颈、全髋、腰椎、全身）和脊柱小梁骨评分（TBS），并通过体内冲击微压痕测量骨材料强度指数（BMSi）。分析糖化血红蛋白（HbA1c）和骨转换标志物。
共纳入33名患有T1D的男性（43±12岁）和28名健康男性对照（42±12岁）。患有T1D的受试者全身BMD低于对照组（P = 0.04）。与对照组相比，患有T1D的男性的TBS和BMSi降低（分别为P = 0.016和P = 0.004），并且患有T1D的受试者骨转换也较低。有无糖尿病并发症的受试者之间的骨参数没有差异。病程与股骨颈BMD呈负相关，但与TBS或BMSi无关。
本研究揭示了患有T1D的男性骨材料强度和微结构受损。此外，我们的数据证实了先前的研究，这些研究发现患有T1D的受试者BMD略有下降且骨转换较低。因此，应将骨视为糖尿病并发症的一个靶点。
