Robust Trabecular Microstructure in Type 2 Diabetes Revealed by Individual Trabecula Segmentation Analysis of HR-pQCT Images.
Robust Trabecular Microstructure in Type 2 Diabetes Revealed by Individual Trabecula Segmentation Analysis of HR-pQCT Images.
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HR-pQCT 图像的个体小梁分割分析揭示了 2 型糖尿病的稳健小梁微观结构。
DOI：
10.1002/jbmr.3465
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Rubin,MishaelaR
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作者：
Starr,JessicaF;Bandeira,LeonardoC;Agarwal,Sanchita;Shah,AnkitM;Nishiyama,KyleK;Hu,Yizhong;McMahon,DonaldJ;Guo,XEdward;Silverberg,ShonniJ;Rubin,MishaelaR
2型糖尿病(T2D)患者骨折风险增加，部分原因可能是皮质骨室内的微结构受损。T2D中有关骨小梁参数的数据相互矛盾。高分辨率外周定量CT(HR-pQCT)保留了骨小梁的微结构，但MRI在T2D上发现了较大的小梁孔，基于DXA的骨小梁评分异常。为了确定与对照组相比，绝经后T2D患者的骨小梁微结构、连通性和排列是否存在差异，我们对92例T2D患者(n= 42)和非T2D患者(n= 50)进行了单独的骨小梁分割(ITS)分析。未校正分析显示，T2D受试者的总骨小梁体积、骨小梁体积分数、骨板数密度、骨板连接密度和胫骨轴向密度增加，骨板组织分数增加，但骨小梁体积分数和骨小梁长度减少(p<； 均为0.05)。调整临床变量后，桡骨和胫骨的板数密度和板连接密度仍然较高，而总的骨小梁体积增加，骨小梁杆长减少。在调整髋部骨密度和骨小梁体积骨密度后，这些差异仍然显著。值得注意的是，T2D持续时间为10年的受试者其质量增加的板状特征，而T2D持续≥为10年的受试者其参数与对照组无差异。总而言之，早期T2D的绝经后妇女有较多的板状和较少的棒状小梁网络。骨小梁质量的这种早期优势不能解释这些患者骨折风险增加的确凿证据，也不能持续到T2D的后期。2018年美国骨与矿物研究学会。
Type 2 diabetes (T2D) patients have an increased fracture risk, which may be partly explained by compromised bone microarchitecture within the cortical bone compartment. Data on trabecular bone parameters in T2D are contradictory. By high‐resolution peripheral quantitative computed tomography (HR‐pQCT), trabecular microarchitecture is preserved, yet larger trabecular holes are detected in T2D by MRI and DXA‐based trabecular bone scores are abnormal. To determine if there are differences in trabecular microstructure, connectivity, and alignment in postmenopausal women with T2D as compared with controls, we performed an individual trabecula segmentation (ITS) analysis on HR‐pQCT scans of the distal radius and tibia in 92 women with (n= 42) and without (n= 50) T2D. Unadjusted analyses showed that T2D subjects had greater total trabecular bone volume, trabecular plate volume fraction, plate number density, plate junction density, and axial alignment at the radius and tibia, and increased plate tissue fraction, but decreased rod tissue fraction and rod length at the radius (p< 0.05 for all). After adjustments for clinical covariates, plate number density and plate junction density remained higher at the radius and tibia, whereas total trabecular bone volume was increased and trabecular rod length was decreased at the radius. These differences remained significant after adjustment for hip BMD and trabecular volumetric bone density. Notably, the increased plate‐like ITS qualities were seen in those with T2D duration of <10 years, whereas ITS parameters in subjects with T2D duration ≥10 years did not differ from those of control subjects. In conclusion, postmenopausal women with early T2D had a greater plate‐like and less rod‐like trabecular network. This early advantage in trabecular plate quality does not explain the well‐established increased fracture risk in these patients and does not persist in the later stage of T2D. © 2018 American Society for Bone and Mineral Research.