Bone Structure and Turnover in Postmenopausal Women With Long-Standing Type 1 Diabetes.
Bone Structure and Turnover in Postmenopausal Women With Long-Standing Type 1 Diabetes.
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骨结构和力学性能受损与1型糖尿病(T1D)骨折风险增加有关。我们通过组织形态计量学研究了患有T1D的绝经后妇女和没有糖尿病的对照组的骨结构和骨转换，采用四环素双标记的过渡骨活检。体内四环素双标记后，绝经后T1D至少10 且无糖尿病的妇女接受了暂时性骨活检。一位对研究组盲目的专家进行了组织形态计量学。进行静态和动态组织形态计量学测量，并比较两组间的差异。分析对象包括9例绝经后T1D妇女(平均年龄58.4 ± 7.1 ，糖尿病37.9 ± 10.9 ，糖化血红蛋白7.1% ± 0.4%)和7例非糖尿病绝经后妇女(平均年龄60.9 ± 3.3 ，糖化血红蛋白5.4% ± 0.2%)。血清甲状旁腺素(38.6 ± 8.1 vs 51.9 ± 23.9 pg/mL)、环磷酰胺(0.4 ± 0.2 vs 0.51 ± 0.34 ng/mL)、P1NP(64.5 ± 26.2 vs 87.3 ± 45.3 ng/mL)差异无统计学意义。T1D组血清25-羟基维生素D水平高于对照组(53.1 ± 20.8vs30.9 ± 8.2 ng/mL，p <； 0.05)。两组之间的骨结构指标(骨体积、骨小梁厚度、骨小梁数量和皮质厚度)相似。骨形成指数(类骨质体积、类骨质表面和骨形成率)在T1D时降低了40%，并与较低的激活频率相关。然而，在骨形成方面的差异并不具有统计学意义。长期存在的T1D可能会影响骨转换，主要是骨形成，而不会明显影响骨结构。需要进一步的研究来了解T1D患者的骨转换及其影响因素。©2023作者。JBMR Plus由威利期刊有限责任公司出版。代表美国骨骼和矿物研究学会。绝经后T1D妇女的骨转换。
Compromised bone structural and mechanical properties are implicated in the increased fracture risk in type 1 diabetes (T1D). We investigated bone structure and turnover by histomorphometry in postmenopausal women with T1D and controls without diabetes using tetracycline double‐labeled transiliac bone biopsy. After in vivo tetracycline double labeling, postmenopausal women with T1D of at least 10 years and without diabetes underwent transiliac bone biopsy. An expert blinded to the study group performed histomorphometry. Static and dynamic histomorphometry measurements were performed and compared between the two groups. The analysis included 9 postmenopausal women with T1D (mean age 58.4 ± 7.1 years with 37.9 ± 10.9 years of diabetes and HbA1c 7.1% ± 0.4%) and 7 postmenopausal women without diabetes (mean age 60.9 ± 3.3 years and HbA1c 5.4% ± 0.2%). There were no significant differences in serum PTH (38.6 ± 8.1 versus 51.9 ± 23.9 pg/mL), CTX (0.4 ± 0.2 versus 0.51 ± 0.34 ng/mL), or P1NP (64.5 ± 26.2 versus 87.3 ± 45.3 ng/mL). Serum 25‐hydroxyvitamin D levels were higher in T1D than in controls (53.1 ± 20.8 versus 30.9 ± 8.2 ng/mL, p < 0.05). Bone structure metrics (bone volume, trabecular thickness, trabecular number, and cortical thickness) were similar between the groups. Indices of bone formation (osteoid volume, osteoid surface, and bone formation rate) were 40% lower in T1D and associated with lower activation frequency. However, the differences in bone formation were not statistically significant. Long‐standing T1D may affect bone turnover, mainly bone formation, without significantly affecting bone structure. Further research is needed to understand bone turnover and factors affecting bone turnover in people with T1D. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research. Bone Turnover in Postmenopausal women with T1D.