Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA, Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria.
Endocrine Division (SEMPR), Hospital de Clinicas, Federal University of Paraná, Curitiba, Brazil.
J Musculoskelet Neuronal Interact. 2022 Sep 1;22(3):305-315.
Patients with type-2 diabetes mellitus (T2DM) have increased risk for bone fractures which points towards impaired bone quality.
We measured bone mineralization density distribution (BMDD) and osteocyte lacunae section (OLS) characteristics based on quantitative backscattered electron images of transiliac biopsy samples from n=26 premenopausal women with T2DM. Outcomes were compared to those from reference cohorts as well as between T2DM subgroups defined by clinical characteristics.
Comparison to references did not reveal any differences in BMDD (all p>0.05) but a lowered OLS-density in cancellous bone in T2DM (-14.9%, p<0.001). Neither BMDD nor OLS-characteristics differed in T2DM subgroups defined by HbA1c (<7% versus >7%). The average degree of bone mineralization (CaMean) was higher (0.44 wt%Ca in T2DM, 0.30 wt%Ca in reference) and consistently the calcium concentration between the tetracycline double labels (CaYoung) was higher (0.76 wt%Ca, all p<0.001) in cancellous versus cortical bone.
Our findings suggest that bone matrix mineralization was neither affected by the presence nor by the glycemic control of T2DM in our study cohort. The intra-individual differences between cancellous and cortical bone mineralization gave evidence for differences in the time course of the early mineralization process in these compartments in general.
2 型糖尿病(T2DM)患者骨折风险增加,表明其骨质量受损。
我们基于定量背散射电子图像,对 26 例绝经前 T2DM 患者的髂骨活检样本进行了骨矿物质化密度分布(BMDD)和骨细胞陷窝面积(OLS)特征测量。将结果与参考队列以及根据临床特征定义的 T2DM 亚组进行了比较。
与参考队列相比,T2DM 患者的 BMDD 没有差异(均 P>0.05),但松质骨中的 OLS 密度降低(-14.9%,P<0.001)。根据 HbA1c(<7%与>7%)定义的 T2DM 亚组,BMDD 或 OLS 特征均无差异。骨矿化程度的平均值更高(T2DM 为 0.44wt%Ca,参考为 0.30wt%Ca),四环素双标记之间的钙浓度也更高(T2DM 为 0.76wt%Ca,均 P<0.001)。
在本研究队列中,T2DM 的存在或血糖控制均未影响骨基质矿化。松质骨和皮质骨之间的个体内矿化差异表明,这些部位的早期矿化过程在时间进程上存在差异。