Diabetes and Deficits in Cortical Bone Density, Microarchitecture, and Bone Size: Framingham HR-pQCT Study.
Diabetes and Deficits in Cortical Bone Density, Microarchitecture, and Bone Size: Framingham HR-pQCT Study.
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糖尿病与皮质骨密度、微结构和骨大小的缺陷：Framingham HR-pQCT 研究。
DOI：
10.1002/jbmr.3240
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发表时间：
2018-01
期刊：
影响因子：
--
通讯作者：
Bouxsein ML
中科院分区：
文献类型：
--
作者：
Samelson EJ;Demissie S;Cupples LA;Zhang X;Xu H;Liu CT;Boyd SK;McLean RR;Broe KE;Kiel DP;Bouxsein ML
通过双能X线吸收法（DXA）测量，2型糖尿病（T2D）老年患者的面积骨矿物质密度（aBMD）往往与非糖尿病患者（非T2D）相同或更高。然而，2型糖尿病患者的骨折风险更高，包括髋部骨折风险增加40% - 50%。我们使用高分辨率外周定量计算机断层扫描（HR - pQCT）来研究2型糖尿病患者骨骼脆弱性的结构机制。我们比较了2型糖尿病患者和非2型糖尿病患者的皮质骨和小梁骨微结构、密度、骨面积以及强度。在二次分析中，我们评估了2型糖尿病与骨测量指标之间的关联是否因既往骨折史、性别和肥胖情况而有所不同。
参与者包括1069名弗雷明汉研究的成员，他们在2005 - 2008年参加检查，并在2012 - 2015年接受了高分辨率外周定量计算机断层扫描。平均年龄为64（±8）岁（范围为40 - 87岁），12%（n = 129）患有2型糖尿病。在对年龄、性别、体重和身高进行调整后，2型糖尿病患者胫骨的皮质体积骨矿物质密度（vBMD）较低（p < 0.01），皮质孔隙率较高（p = 0.02），横截面积较小（p = 0.04），但桡骨无此情况。2型糖尿病患者的小梁骨指标与非2型糖尿病患者相似或更优。2型糖尿病与骨测量指标之间的关联不因性别或肥胖状况而不同（所有交互作用p > 0.05），然而在有既往骨折史和无骨折史的患者中，这种关联有所不同。具体而言，2型糖尿病患者胫骨的皮质体积骨矿物质密度和桡骨的皮质厚度低于非2型糖尿病患者，但仅在有既往骨折史的个体中如此。2型糖尿病患者桡骨的皮质孔隙率高于非2型糖尿病患者，但仅在无既往骨折史的个体中如此。
这项针对老年人的大型社区研究结果表明，皮质骨的适度退化和骨面积的减少可能是老年2型糖尿病患者骨骼疾病的特征。需要评估这些缺陷作为2型糖尿病患者骨折的预测因素，以便在这一快速增长的老年人群中制定预防策略。
Older adults with type 2 diabetes (T2D) tend to have normal or greater areal bone mineral density (aBMD), as measured by DXA, than those who do not have diabetes (non-T2D). Yet, risk of fracture is higher in T2D, including 40%–50% increased hip fracture risk. We used HR-pQCT to investigate structural mechanisms underlying skeletal fragility in T2D. We compared cortical and trabecular bone microarchitecture, density, bone area, and strength in T2D and non-T2D. In secondary analyses we evaluated whether associations between T2D and bone measures differed according to prior fracture, sex, and obesity. Participants included 1,069 members of the Framingham Study, who attended examinations 2005–2008 and underwent HR-pQCT scanning in 2012–2015. Mean age was 64 (±8) years (range, 40–87), and 12% (n=129) had T2D. After adjustment for age, sex, weight, and height, T2D had lower cortical vBMD (p<0.01), higher cortical porosity (p=0.02), and smaller cross-sectional area (p=0.04) at the tibia, but not radius. Trabecular indices were similar or more favorable in T2D than non-T2D. Associations between T2D and bone measures did not differ according to sex or obesity status (all interaction p>0.05), however associations did differ in those with a prior fracture and those with no history of fracture. Specifically, cortical vBMD at the tibia and cortical thickness at the radius were lower in T2D than non-T2D, but only among those individuals with a prior fracture. Cortical porosity at the radius was higher in T2D than non-T2D, but only among those who did not have a prior fracture. Findings from this large, community-based study of older adults suggest that modest deterioration in cortical bone and reductions in bone area may characterize diabetic bone disease in older adults. Evaluation of these deficits as predictors of fracture in T2D is needed to develop prevention strategies in this rapidly increasing population of older adults.
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DOI：
10.1002/jbmr.2530
发表时间：
2015-10
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：
Chan JJ;Cupples LA;Kiel DP;O'Donnell CJ;Hoffmann U;Samelson EJ
通讯作者：
Samelson EJ
影响因子：
8.2
作者：
Forsén, L;Meyer, HE;Edna, TH
通讯作者：
Edna, TH
影响因子：
5.8
作者：
Boutroy, S;Bouxsein, ML;Delmas, PD
通讯作者：
Delmas, PD
影响因子：
--
作者：
Reinartz, P;Mumme, T;Buell, U
通讯作者：
Buell, U
影响因子：
2.6
作者：
Huang, Yueh-Fang;Shyu, Yea-Ing L.;Wu, Chi-Chuan
通讯作者：
Wu, Chi-Chuan