Department of Endocrinology and Metabolic Diseases, University General Hospital of Larissa, Larissa, Greece.
Department of Pathology, General Hospital of Larissa, Larissa, Greece.
J Diabetes Res. 2023 Jun 15;2023:8925956. doi: 10.1155/2023/8925956. eCollection 2023.
Bone mineral density (BMD) was measured in uncomplicated young adult patients with type 1 diabetes mellitus (T1DM) and sex- and age-matched controls, using both dual X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) to investigate their diagnostic ability in detecting abnormal values in these patients.
118 patients with T1DM (65 females, mean age 30.12 ± 8.78 years) and 94 sex- and age-matched controls were studied. BMD was assessed in all participants by DXA and QCT at lumbar spine (LS). Biochemical markers of bone metabolism were also measured.
T1DM was associated with lower BMD at L1-L3 vertebrae measured by both DXA and QCT and lower bone turnover compared to sex- and age-matched controls. In T1DM subjects, QCT detected more patients with abnormal BMD values compared to DXA. BMI and HbA1c levels were the only determinants of BMD. Bone turnover markers were lower in patients with longer duration of diabetes.
QCT provides a higher sensitivity compared to DXA in detecting abnormal BMD values in patients with uncomplicated T1DM. In these patients, the diabetes-related decreased BMD may be present early, before it is detected by DXA, the clinical gold standard for BMD measurements, and before the presence of any other diabetes complications, stressing the importance of an early intervention for fracture prevention.
通过双能 X 射线吸收法（DXA）和定量计算机断层扫描（QCT）测量 1 型糖尿病（T1DM）患者和性别、年龄匹配的对照组的骨密度（BMD），以研究其在检测这些患者异常值方面的诊断能力。
研究了 118 例 T1DM 患者（65 名女性，平均年龄 30.12±8.78 岁）和 94 名性别和年龄匹配的对照组。所有参与者均通过 DXA 和 QCT 在腰椎（LS）进行 BMD 评估。还测量了骨代谢生化标志物。
与性别和年龄匹配的对照组相比，T1DM 患者的 DXA 和 QCT 测量的 L1-L3 椎体 BMD 较低，骨转换率也较低。在 T1DM 患者中，与 DXA 相比，QCT 检测到更多 BMD 值异常的患者。BMI 和 HbA1c 水平是 BMD 的唯一决定因素。糖尿病持续时间较长的患者骨转换标志物较低。
与 DXA 相比，QCT 在检测未经治疗的 T1DM 患者的异常 BMD 值方面具有更高的敏感性。在这些患者中，糖尿病相关的 BMD 减少可能在 DXA 检测到之前就已经存在，而 DXA 是 BMD 测量的临床金标准，并且在任何其他糖尿病并发症出现之前，这强调了早期干预预防骨折的重要性。
