Aggarwal Tanushi, Shah Ravi, Pal Rimesh, Rastogi Ashu, Singla Veenu, Bhadada Sanjay K
Department of Cardiology, PGIMER, Chandigarh, India.
Department of Endocrinology, PGIMER, Chandigarh, India.
Indian J Endocrinol Metab. 2025 Jan-Feb;29(1):43-48. doi: 10.4103/ijem.ijem_310_24. Epub 2025 Feb 28.
Type 2 diabetes mellitus (T2DM) increases the risk of fragility fractures, despite the fact that areal bone mineral density (aBMD) is either increased or normal compared to healthy non-diabetic subjects. Hence, the trabecular bone score (TBS) is under investigation in this patient cohort as an alternative metric for the assessment of bone health. The present study aimed to determine TBS in post-menopausal women diagnosed with T2DM and in non-diabetic individuals.
This cross-sectional study enrolled 101 individuals with T2DM and 101 individuals without overt T2DM (43 individuals with pre-diabetes and 58 normoglycaemic individuals). Participants underwent a comprehensive history and physical examination, biochemical investigations, and a dual-energy X-ray absorptiometry (DXA) scan with TBS measurement.
Post-menopausal women with T2DM did not exhibit any significant difference in aBMD levels in comparison to those with pre-diabetes or normoglycaemic individuals. Although there was no statistically significant difference in aBMD among the three groups, the mean TBS value was significantly lower in the T2DM group when compared to both comparison groups ( < 0.001). Additionally, glycated haemoglobin (HbA1c) and the duration of diabetes demonstrated a significant negative correlation with TBS.
TBS may serve as a valuable tool for assessing bone health in individuals with T2DM, particularly when aBMD does not accurately predict the risk of fragility fractures. Both glycaemic control and the duration of diabetes significantly impact TBS values. In individuals with T2DM, incorporating TBS measurements alongside aBMD assessments could offer a more comprehensive evaluation of their bone health.
2型糖尿病（T2DM）会增加脆性骨折的风险，尽管与健康的非糖尿病受试者相比，其骨面积密度（aBMD）要么升高要么正常。因此，本患者队列正在研究小梁骨评分（TBS），作为评估骨骼健康的替代指标。本研究旨在确定诊断为T2DM的绝经后女性和非糖尿病个体的TBS。
这项横断面研究纳入了101名T2DM患者和101名无明显T2DM的个体（43名糖尿病前期个体和58名血糖正常个体）。参与者接受了全面的病史和体格检查、生化检查以及带有TBS测量的双能X线吸收法（DXA）扫描。
与糖尿病前期个体或血糖正常个体相比，患有T2DM的绝经后女性的aBMD水平没有显著差异。尽管三组之间的aBMD没有统计学上的显著差异，但与两个对照组相比，T2DM组的平均TBS值显著更低（<0.001）。此外，糖化血红蛋白（HbA1c）和糖尿病病程与TBS呈显著负相关。
TBS可能是评估T2DM个体骨骼健康的有价值工具，特别是当aBMD不能准确预测脆性骨折风险时。血糖控制和糖尿病病程均会显著影响TBS值。在T2DM个体中，将TBS测量与aBMD评估相结合可以更全面地评估他们的骨骼健康。
