Lin Yunyun, Tang Juanjuan, Xue Cheng, Di Wenjuan, Cheng Peng
Department of Gerontology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, Lishui, People's Republic of China.
Department of Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
Sci Rep. 2025 Jan 13;15(1):1764. doi: 10.1038/s41598-025-85235-4.
Patients with Type 2 diabetes mellitus(T2DM) typically have an average or higher bone mineral density (BMD) but are at a significantly higher risk of fracture than patients without diabetes. Trabecular bone score (TBS) is a textural index derived from pixel gray-level variations in lumbar spine DXA image, which has been introduced as an indirect measure of bone quality. This study aimed to discuss the trends and annual rates of change in BMD and TBS with age in Chinese men with T2DM and men without diabetes mellitus. Lumbar spine(LS) TBS was significantly lower in males with T2DM compared to men without diabetes(1.279 ± 0.117 vs. 1.299 ± 0.090, P = 0.005). However, TBS in men with T2DM peaked around age 60, which occurred later and was lower than the peak observed in men without diabetes, who reached their peak TBS around age 50 (1.294 ± 0.126 vs. 1.328 ± 0.088). Femoral neck, total hip, and lumbar spine BMD in men with T2DM were not significantly different from those in men without diabetes. The results showed that both men with or without T2DM exhibited the lowest annual rates of change in TBS at 66-75 years of age, with values of -1.05%(P < 0.001) and - 0.90%(P < 0.001), respectively. Patients with great glycemic control demonstrated higher TBS and BMD. Men with T2DM have later and lower peak TBS and faster bone loss, suggesting that diabetes may negatively impact bone microarchitecture and mineralization.
2型糖尿病（T2DM）患者的骨矿物质密度（BMD）通常处于平均水平或更高，但与非糖尿病患者相比，其骨折风险显著更高。小梁骨评分（TBS）是一种从腰椎双能X线吸收法（DXA）图像的像素灰度变化得出的纹理指数，已被用作骨质量的间接测量指标。本研究旨在探讨中国T2DM男性和非糖尿病男性中BMD和TBS随年龄变化的趋势和年变化率。与非糖尿病男性相比，T2DM男性的腰椎（LS）TBS显著更低（1.279±0.117 vs. 1.299±0.090，P = 0.005）。然而，T2DM男性的TBS在60岁左右达到峰值，这一峰值出现的时间较晚且低于非糖尿病男性，后者在50岁左右达到TBS峰值（1.294±0.126 vs. 1.328±0.088）。T2DM男性的股骨颈、全髋和腰椎BMD与非糖尿病男性相比无显著差异。结果显示，66 - 75岁时，T2DM男性和非糖尿病男性的TBS年变化率均最低，分别为-1.05%（P < 0.001）和-0.90%（P < 0.001）。血糖控制良好的患者TBS和BMD更高。T2DM男性的TBS峰值出现时间较晚且更低，骨质流失更快，这表明糖尿病可能对骨微结构和矿化产生负面影响。
