Hip geometry in diabetic women: implications for fracture risk.
Hip geometry in diabetic women: implications for fracture risk.
复制标题
DOI：
10.1016/j.metabol.2012.05.010
复制
发表时间：
2012-12
影响因子：
9.8
通讯作者：
LeBoff, Meryl S.
中科院分区：
文献类型：
--
作者：
Garg, Rajesh;Chen, Zhao;Beck, Thomas;Cauley, Jane A.;Wu, Guanglin;Nelson, Dorothy;Lewis, Beth;LaCroix, Andrea;LeBoff, Meryl S.
与没有糖尿病的女性相比，患有2型糖尿病(T2 DM)的女性尽管骨密度(BMD)增加，但发生骨折的风险更高。我们假设，在考虑了瘦体重后，T2 DM女性的骨强度降低，这可能是导致她们骨折风险增加的原因之一。妇女健康倡议观察性研究的参与者包括在这项横断面研究中。这些分析包括3组妇女：1)正在节食或口服降糖药的T2 DM妇女(n=299)；2)接受胰岛素治疗(包括或不使用口服药物)的T2 DM妇女(n=128)；以及3)非糖尿病对照组妇女(n=5497)。在双能X线骨密度仪(DXA)的髋关节扫描上，使用Beck方法进行髋关节结构分析。我们比较了在校正和不校正整体DXA瘦体重的情况下，窄颈处的骨密度和截面弹性系数(弯曲强度)。这三组女性的年龄(分别为63.7岁、64.6岁和64.2岁)和身高相似，但患有T2 DM的女性比对照组更重，瘦体重更重(P<；0.001)。两组糖尿病患者的绝对骨密度和截面模数均高于对照组。然而，在调整了总瘦体重后，服用胰岛素的糖尿病女性的骨密度和截面弹性系数显著降低。经瘦身体重调整后，接受胰岛素治疗的糖尿病女性股骨颈骨密度和弯曲强度显著低于对照组。这可能代表了骨骼模型适应性的改变，并解释了T2 DM患者骨折风险较高的原因。
Women with type 2 diabetes mellitus (T2DM) have a higher risk of fractures despite increased bone mineral density (BMD) as compared to women without diabetes. We hypothesized that bone strength is diminished in women with T2DM after accounting for lean body mass, which may contribute to their increased fracture risk. Participants from Women’s Health Initiative Observational Study were included in this cross-sectional study. These analyses include 3 groups of women: 1) T2DM women on diet or oral hypoglycemic agents (n=299); 2) T2DM women on insulin therapy (with or without oral agents) (n=128); and 3) Non-diabetic control women (n=5497). Hip structural analyses were done using the validated Beck’s method on hip scans from dual energy x-ray absorptiometry (DXA). We compared BMD and section modulus (bending strength) at the narrow neck with and without correcting for total body DXA lean body mass. Women in all three groups were of similar ages (63.7, 64.6 and 64.2 years, respectively) and heights, but those with T2DM were heavier, with greater lean body weight vs. controls (p<0.001). In both diabetic groups, absolute BMD and section modulus were higher compared with controls. However, after adjusting for total lean body weight, diabetic women on insulin had significantly lower BMD and section modulus. Adjusted for lean body weight, the BMD and bending strength in the femoral neck are significantly lower in insulin - treated diabetic women vs. controls. This may represent altered adaptation of bone modeling and explain the higher fracture risk in patients with T2DM.
登录
查看更多内容
影响因子：
4.1
作者：
Napoli N;Pedone C;Pozzilli P;Lauretani F;Ferrucci L;Incalzi RA
通讯作者：
Incalzi RA
DOI：
10.1002/jbmr.430
发表时间：
2011-09
期刊：
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
影响因子：
--
作者：
Chen Z;Qi L;Beck TJ;Robbins J;Wu G;Lewis CE;Cauley JA;Wright NC;Seldin MF
通讯作者：
Seldin MF
影响因子：
7.7
作者：
Park, Seok Won;Goodpaster, Bret H.;Newman, Anne B.
通讯作者：
Newman, Anne B.
影响因子：
6.2
作者：
Strotmeyer, ES;Cauley, JA;Newman, AB
通讯作者：
Newman, AB
影响因子：
5.8
作者：
Burghardt, Andrew J.;Issever, Ahi S.;Link, Thomas M.
通讯作者：
Link, Thomas M.