Middle-aged premenopausal women with type 1 diabetes have lower bone mineral density and calcaneal quantitative ultrasound than nondiabetic women
Middle-aged premenopausal women with type 1 diabetes have lower bone mineral density and calcaneal quantitative ultrasound than nondiabetic women
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DOI：
10.2337/diacare.29.02.06.dc05-1353
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发表时间：
2006-02-01
期刊：
影响因子：
16.2
通讯作者：
Dorman, JS
中科院分区：
文献类型：
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作者：
Strotmeyer, ES;Cauley, JA;Dorman, JS
目的 - 确定与非糖尿病女性相比，患有 1 型糖尿病的中年绝经前女性是否有更多的自我报告骨折和较低的骨矿物质密度 (BMD)。 研究设计和方法 - 参与者是年龄 35 - 55 岁的患有 1 型糖尿病（n = 67；病程 32.2 +/- 5.3 年）和无糖尿病 (n = 237) 的绝经前女性。通过双 X 射线骨密度仪测量全髋、股骨颈、全身和脊柱 BMD。通过定量超声评估跟骨宽带超声衰减 (BUA)。 结果 - 与非糖尿病女性相比，1 型糖尿病女性更有可能在 20 岁后报告骨折（33.3% vs. 22.6%；年龄调整比值比 1.89 [95% CI 1.02 - 3.49]）。 1 型糖尿病与较低的髋部总 BMD（0.890 对比 0.961 g/cm(2)；P < 0.001）、股骨颈 BMD（0.797 对比 0.847 g/cm(2)；p = 0.001）、全身 BMD（1.132 对比 1.165 g/cm(2)；p < 0.01）和更低相关多变量调整后的跟骨 BUA（71.6 与 84.9 dB/MHz；P < 0.001）。与对照组女性相比，1 型糖尿病患者的 BMD 降低了 3-8%，跟骨 BUA 降低了 15%。脊柱 BMD 和骨重建生物标志物在各组之间没有显着差异。在 1 型糖尿病女性中，单丝检测的减少和失明均与较低的 BMD 相关。结论 - 患有 1 型糖尿病的绝经前女性的较低 BMD 可能会大大增加她们绝经后患骨质疏松症的风险。 1 型糖尿病女性在更年期过渡时应成为骨质疏松症筛查的目标，并可能预防骨折。
OBJECTIVE - To determine whether middle-aged premenopausal women with type 1 diabetes had more self-reported fractures and lower bone mineral density (BMD) compared with nondiabetic women.RESEARCH DESIGN AND METHODS - Participants were premenopausal women aged 35 - 55 years with type 1 diabetes (n = 67; 32.2 +/- 5.3 years duration) and without diabetes (n = 237). Total hip, femoral neck, whole-body, and spine BMD were measured by dual X-ray absorptiometry. Calcaneal broadband ultrasound attenuation (BUA) was assessed with quantitative ultrasound.RESULTS - Women with type 1 diabetes were more likely to report a fracture after age 20 years compared with nondiabetic women (33.3 vs. 22.6%; age-adjusted odds ratio 1.89 [95% CI 1.02 - 3.49]). Type 1 diabetes was associated with lower total hip BMD (0.890 vs. 0.961 g/cm(2); P < 0.001), femoral neck BMD (0.797 vs. 0.847 g/cm(2); p = 0.001), whole-body BMD (1.132 vs. 1.165 g/cm(2); p < 0.01), and lower calcaneal BUA (71.6 vs. 84.9 dB/MHz; P < 0.001) after multivariate adjustment. BMD was 3-8% lower in type 1 diabetic compared with control women and calcaneal BUA was 15% lower. Spine BMD and biomarkers of bone remodeling were not significantly different between groups. In the type1 diabetic women, reduced monofilament detection and blindness were both associated with lower BMD.CONCLUSIONS - Lower BMD in premenopausal women with type 1 diabetes may substantially increase their risk of developing osteoporosis after menopause. Type 1 diabetic women should be targeted for osteoporosis screening and possible fracture prevention as they transition through menopause.