Krishnan Sowmya, Aston Christopher E, Chadwick Jennifer, Gulati Shelly, Wang Huaiwen, Sisson Susan B, Misra Madhusmita, Chernausek Steven D
Department of Pediatrics, Harold Hamm Diabetes Center, University of Oklahoma Health Science Center, Oklahoma City, USA.
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, USA.
Diabetol Metab Syndr. 2025 Apr 2;17(1):113. doi: 10.1186/s13098-025-01677-w.
Both type 1 and type 2 diabetes mellitus (T1D and T2D) are associated with poor bone health and an increased risk of fracture in adults. However, there are limited data regarding the effects of diabetes on the growing skeleton, particularly during adolescence, the time of peak bone mineral accretion. The purpose of this study was to examine differences in markers of bone health and factors that influence bone health in White adolescents and young adults with well-controlled T1D (n = 17; Average A1C 7.45 ± 1.15%) and control participants without T1D (n = 13). Age across both groups was similar (17.41 ± 1.62 years for T1D vs. 17.46 ± 1.45 years for controls) as was BMI and height. Bone density was measured at the lumbar spine, whole body, and proximal femur sites using the GE HealthCare's Lunar iDXA (GE; v11-30.062) in all subjects. Hip structural analysis (HSA) was performed at the proximal femur and Trabecular Bone Score (TBS) was calculated from AP spine image using Trabecular Osteo Software from Medimaps. Markers of bone formation, resorption, serum sclerostin and urine pentosidine were measured in all subjects. No difference in total body bone mineral density (BMD), lumbar spine BMD, lumbar spine BMAD, dual femur BMD, HSA variables or TBS measures were noted between subjects with T1D and controls. However, duration of diabetes had a significant negative correlation (p: 0.035) with cross-sectional moment of inertia (a measure of resistance to bending forces) in subjects with T1D. IGF-1 levels were marginally lower in the group with T1D (p:0.06) and had a significant inverse relationship (r: -0.406, p:0.026) with mean hip axis angle; a known predictor of hip fractures. TBS score had a marginally significant negative correlation with urinary pentosidine (a marker for collagen glycosylation) across both groups after adjusting for age (r: -0.343, p: 0.07), suggesting increased collagen glycosylation has an adverse impact on bone microarchitecture. CLINICAL TRIAL NUMBER: Not applicable.
1型和2型糖尿病（T1D和T2D）均与成人骨骼健康状况不佳及骨折风险增加相关。然而，关于糖尿病对生长中骨骼的影响的数据有限，尤其是在青春期这个骨矿物质积累高峰期。本研究的目的是比较血糖控制良好的白人青少年和年轻成人T1D患者（n = 17；平均糖化血红蛋白A1C 7.45±1.15%）与无T1D的对照参与者（n = 13）在骨骼健康标志物及影响骨骼健康的因素方面的差异。两组的年龄相似（T1D组为17.41±1.62岁，对照组为17.46±1.45岁），体重指数（BMI）和身高也相似。所有受试者均使用GE医疗的Lunar iDXA（GE；v11 - 30.062）在腰椎、全身和股骨近端部位测量骨密度。在股骨近端进行髋部结构分析（HSA），并使用Medimaps的小梁骨软件根据前后位脊柱图像计算小梁骨评分（TBS）。在所有受试者中测量骨形成、骨吸收标志物、血清硬化蛋白和尿戊糖苷。T1D患者与对照组在全身骨矿物质密度（BMD）、腰椎BMD、腰椎骨小梁平均密度（BMAD）、双侧股骨BMD、HSA变量或TBS测量值方面均未发现差异。然而，糖尿病病程与T1D患者的截面惯性矩（一种抗弯曲力的测量指标）呈显著负相关（p：0.035）。T1D组的胰岛素样生长因子-1（IGF - 1）水平略低（p：0.06），且与平均髋轴角呈显著负相关（r： - 0.406，p：0.026）；髋轴角是髋部骨折的已知预测指标。在调整年龄后，两组的TBS评分与尿戊糖苷（一种胶原糖基化标志物）呈边缘显著负相关（r： - 0.343，p：0.07），表明胶原糖基化增加对骨微结构有不利影响。临床试验编号：不适用。
