Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Arch Osteoporos. 2024 Oct 4;19(1):94. doi: 10.1007/s11657-024-01450-y.
Bone microarchitecture, as assessed using high-resolution peripheral quantitative computed tomography, is adversely affected in postmenopausal women with type 2 diabetes mellitus having sarcopenia/sarcopenic obesity while areal bone mineral density does not differ between those with and without sarcopenia.
Type 2 diabetes (T2D) increases the risk of sarcopenia, which independently contributes to bone fragility. We aimed to explore the association between sarcopenia/sarcopenic obesity and bone quality using second-generation high-resolution peripheral quantitative computed tomography (HR-pQCT) in T2D.
We analyzed the baseline participant characteristics of an ongoing randomized clinical pilot trial (CTRI/2022/02/039978). Postmenopausal women (≥ 50 years) with T2D and high risk of fragility fractures were included. Areal BMD (aBMD), trabecular bone score (TBS), and body composition were measured using DXA. Bone microarchitecture was assessed at distal radius/distal tibia using HR-pQCT. Muscle strength was estimated using dominant handgrip strength (HGS). Sarcopenia was defined as low HGS (< 18.0 kg) and low appendicular skeletal muscle index (ASMI) (< 4.61 kg/m). Probable sarcopenia was defined as low HGS with normal ASMI. Sarcopenic obesity was classified as co-existence of sarcopenia and obesity (BMI ≥ 25.0 kg/m).
We recruited 129 postmenopausal women (mean age 64.2 ± 6.7 years). Participants were categorized into four mutually exclusive groups: group A (normal HGS and ASMI, n = 17), group B (probable sarcopenia, n = 77), group C (non-obese sarcopenia, n = 18), and group D (obese sarcopenia, n = 18). The four groups did not differ significantly with regard to baseline characteristics, fracture prevalence, HbA1c, aBMD, and TBS. However, HR-pQCT-derived volumetric BMD and cortical/trabecular microarchitecture were significantly poorer in group C/group D than in group A/group B.
Bone quality rather than bone density (quantity) is adversely affected in T2D postmenopausal women with sarcopenia/sarcopenic obesity, which could increase the fracture risk in this patient sub-population.
2 型糖尿病（T2D）会增加发生肌少症的风险，而肌少症会独立导致骨骼脆弱。我们旨在使用第二代高分辨率外周定量计算机断层扫描（HR-pQCT）探讨 T2D 患者中肌少症/肌少症性肥胖与骨质量之间的关系。
我们分析了一项正在进行的随机临床试点试验（CTRI/2022/02/039978）的基线参与者特征。纳入绝经后（≥50 岁）患有 T2D 且有脆性骨折高风险的女性。通过双能 X 线吸收法（DXA）测量骨密度（aBMD）、骨小梁评分（TBS）和身体成分。使用 HR-pQCT 评估远端桡骨/胫骨的骨微结构。使用优势手握力（HGS）估计肌肉力量。肌少症定义为低 HGS（<18.0kg）和低四肢骨骼肌指数（ASMI）（<4.61kg/m）。疑似肌少症定义为 HGS 低但 ASMI 正常。肌少症性肥胖定义为肌少症和肥胖共存（BMI≥25.0kg/m）。
我们招募了 129 名绝经后女性（平均年龄 64.2±6.7 岁）。参与者分为四个互斥的组别：A 组（HGS 和 ASMI 正常，n=17）、B 组（疑似肌少症，n=77）、C 组（非肥胖性肌少症，n=18）和 D 组（肥胖性肌少症，n=18）。这四组在基线特征、骨折患病率、HbA1c、aBMD 和 TBS 方面无显著差异。然而，与 A 组/B 组相比，C 组/D 组的 HR-pQCT 衍生的体积 BMD 和皮质/小梁微观结构明显较差。
与 T2D 绝经后女性的骨密度（量）相比，骨质量（质）在肌少症/肌少症性肥胖患者中受到不利影响，这可能会增加该患者亚群的骨折风险。
