Bone material strength in normoglycemic and hyperglycemic adults

血糖正常和高血糖成人的骨材料强度

• 批准号: 9102349
• 负责人: Bess Dawson-Hughes
• 金额: $ 23.43万
• 依托单位: TUFTS UNIVERSITY BOSTON
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-05 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9102349
• 关键词: 25-hydroxyvitamin D; Address; Adult; Advanced Glycosylation End Products; Affect; Age; Anterior; Blood Glucose; Blood specimen; Body Composition; Body Weight; Bone Density; Bone Diseases; Caring; Categories; Characteristics; Clinical; Clinical Management; Clinical Trials; Cost Measures; Creatinine; Cross-Sectional Studies; Diabetes Mellitus; Diet; Dual-Energy X-Ray Absorptiometry; Ethnic Origin; Evaluation; Fasting; Fracture; Future; Glucose; Glycosylated hemoglobin A; Goals; Health; Healthcare; Hip Fractures; Hyperglycemia; Image; Individual; Intake; Intermediate Variables; Intervention; Intervention Studies; Life Style; Link; Measurement; Measures; Mediator of activation protein; Medical; Methods; Morbidity - disease rate; Non-Insulin-Dependent Diabetes Mellitus; Nutrient; Outcome Measure; Patients; Physical activity; Plasma; Population; Prediabetes syndrome; Questionnaires; Race; Renal function; Research Design; Risk; Scanning; Secondary to; Serum; Site; Staging; Testing; Urine; Vertebral column; Vitamin D; base; bone; bone quality; bone strength; cost; diabetic; fasting glucose; improved; instrument; lifestyle factors; minimally invasive; new technology; non-diabetic; pentosidine; potential biomarker; prevent; public health relevance; sex; skeletal; substantia spongiosa; tibia; tool; urinary

 DESCRIPTION (provided by applicant): Fractures of the hip and other sites are increased nearly two-fold in patients with type 2 diabetes despite their having higher bone mineral density (BMD) than others. This suggests that bone qualities other than BMD, including bone material strength (BMS) and trabecular bone score (TBS), are compromised in diabetes. Most measurements of bone strength are expensive and impractical for use in health care settings or in large clinical trials. It is therefore important to identify more practical methods that can be used to investigate the effects of hyperglycemia on skeletal health and how interventions may improve skeletal health in diabetes. The proposed project evaluates recently developed measures of bone quality, BMS and TBS, as they relate to glycemia. The ability to use straightforward clinical tests to identify individuals who may be at risk for diabetic skeletal fragility would address a critical barrier in the field and would have major impact on clinical management of skeletal fragility associated with diabetes. The overall goal of the proposed project is to obtain preliminary information about BMS and TBS as potential clinical indicators of fracture risk among individuals with prediabetes and diabetes and as potential outcome measures in future clinical trials of diabetes interventions. Information gained from the proposed study is expected to justify and facilitate the inclusion of two low cost, minimally invasive measures of bone quality as primary or secondary measures in intervention studies designed to prevent and treat type two diabetes and its sequelae including fractures. The proposed cross-sectional study investigates associations of glycemia and other subject characteristics with BMS and TBS in 200 adults (age 50+) with normoglycemia, prediabetes and untreated diabetes. BMS measurement of the non-dominant anterior mid-tibia will be measured with a minimally invasive handheld instrument. TBS will be derived from spine DXA scan images. Other measurements include bone density scans of the same mid-tibial site and other skeletal sites, as well as other physical measurements and medical and lifestyle information obtained by questionnaire. One fasting blood sample will be analyzed for HbA1c, plasma glucose, serum creatinine and 25- hydroxyvitamin D, and urinary pentosidine. Analyses will examine associations of glycemic status, physical and lifestyle characteristics with BMS and TBS and will examine differences in these measures across demographic categories and diabetes status groups.

 描述（由申请人提供）：2型糖尿病患者的髋关节和其他部位骨折增加了近两倍，尽管他们的骨矿物质密度（BMD）比其他人高。这表明除了BMD以外的骨质量，包括骨材料强度（BMS）和骨小梁评分（TBS），在糖尿病中受到损害。大多数骨强度的测量是昂贵的，并且对于在医疗保健环境或大型临床试验中使用是不切实际的。因此，重要的是要确定更实用的方法，可用于调查高血糖对骨骼健康的影响，以及如何干预可以改善糖尿病骨骼健康。拟议的项目评估最近开发的骨质测量，BMS和TBS，因为它们与骨密度有关。使用简单的临床测试来识别可能处于糖尿病骨骼脆弱性风险中的个体的能力将解决该领域的关键障碍，并将对与糖尿病相关的骨骼脆弱性的临床管理产生重大影响。拟议项目的总体目标是获得有关BMS和TBS的初步信息，作为糖尿病前期和糖尿病患者骨折风险的潜在临床指标，并作为未来糖尿病干预临床试验的潜在结果指标。从拟议的研究中获得的信息预计将证明并促进纳入两种低成本，微创骨质测量作为干预研究的主要或次要措施，旨在预防和治疗2型糖尿病及其后遗症，包括骨折。这项横断面研究调查了200名年龄在50岁以上、血糖正常、糖尿病前期和未经治疗的糖尿病患者的BMI和其他受试者特征与BMS和TBS的相关性。将使用微创手持式仪器测量非优势胫骨前中部的BMS测量值。TBS将来自脊柱DXA扫描图像。其他测量包括同一胫骨中段部位和其他骨骼部位的骨密度扫描，以及其他身体测量和通过问卷调查获得的医疗和生活方式信息。将分析一份空腹血液样本的HbA 1c、血糖、血清肌酐和25-羟基维生素D以及尿戊糖苷。分析将检查血糖状态、身体和生活方式特征与BMS和TBS的相关性，并检查这些指标在人口统计学类别和糖尿病状态组中的差异。