Comparison of differences in bone microarchitecture in adult- versus juvenile-onset type 1 diabetes Asian males versus non-diabetes males: an observational cross-sectional pilot study

Abstract

Purpose Evidence about bone microarchitecture in Asian type 1 diabetes (T1D) patients is lacking. We assessed the bone microarchitecture in T1D patients versus controls and compare the differences between juvenile-onset and adult-onset T1D patients. Methods This cross-sectional study recruited 32 Asian males with T1D and 32 age-, sex-, and body mass index (BMI)-matched controls. Dual-energy X-ray absorptiometry (DXA) and high-resolution peripheral quantitative computed tomography (HR-pQCT) for ultradistal nondominant radius and tibia were performed. The data were analyzed using Student’s t test and analysis of covariance. Results Among the patients, 15 had juvenile-onset T1D, with a median disease duration of 11 years, and 17 had adult-onset T1D, with a median disease duration of 7 years. At the radius, adult-onset and juvenile-onset T1D patients had lower total volumetric bone mineral density (vBMD), trabecular vBMD, trabecular bone volume fraction (BV/TV), and trabecular thickness (Tb.Th) (p < 0.05) than the control subjects. After adjusting for BMI, disease duration, and insulin dose, juvenile-onset patients tended to have lower trabecular vBMD, BV/TV, Tb.Th, and intracortical porosity (Ct.Po) than adult-onset patients. At the tibia, adult-onset patients displayed lower total vBMD, lower Ct. vBMD, and higher Ct.Po (p < 0.05), while juvenile-onset patients had lower Tb.Th and standard deviation of trabecular number (1/Tb.N.SD) (p < 0.05) than control subjects. After adjustment for covariates, adult-onset patients tended to have higher cortical pore diameter (Ct.Po.Dm) than juvenile-onset patients. Conclusions T1D patients were associated with compromised bone microarchitecture, adult-onset and juvenile-onset T1D patients demonstrated some differences in cortical and trabecular microarchitecture.

Liraglutide Inhibits Osteoclastogenesis and Improves Bone Loss by Downregulating Trem2 in Female Type 1 Diabetic Mice: Findings From Transcriptomics

“…Previous studies have found low bone turnover especially reduced bone formation in the T1D context ( 26 ); however, the bone resorption can be enhanced, inhibited, or unaltered, which might be attributed to the timing of onset of T1D, the duration of diabetes, and the disease-associated inflammatory environment ( 27 ). In our study, STZ-induced T1D mice showed significantly elevated blood glucose for an enough duration (at least 8 weeks), resulting in decreased BMD and compromised microarchitectures, which was consistent with previous clinical and animal studies ( 3 , 14 , 25 , 28 ), indicating our successful establishment of the disease model. Thus, the STZ-induced T1D model could be a convenient and reliable model for studying T1D-related bone loss.…”

“…Compared with bone histomorphology or local gene expression, serum turnover markers may be less sensitive. In our study and other studies, serum CTX or P1NP in T1D patients was within the normal range or similar to the control groups, while micro-CT found significant compromised microarchitectures (3,25). Previous studies have found low bone turnover especially reduced bone formation in the T1D context (26); however, the bone resorption can be enhanced, inhibited, or unaltered, which might be attributed to the timing of onset of T1D, the duration of diabetes, and the disease-associated inflammatory environment (27).…”

“…These complications include diabetic nephropathy, diabetic retinopathy, and diabetic neuropathy. In addition, skeletal fragility has also been associated with type 1 diabetes, which exhibited as deficits in bone mineral density (BMD) and bone microarchitectures compared with controls, leading to increased fracture risks ( 2 , 3 ).…”

Imaging techniques to study diabetic bone disease

“…However, subjects with long-standing T1D manifested impairments in cortical vBMD, cortical bone thickness, and estimated strength and stiffness at the ultradistal tibia, that were reported to be determined by diabetic neuropathy [27 && ]. These findings disagree with previous studies assessing bone microstructure with HR-pQCT where impairments in trabecular bone were reported in subjects with T1D compared to controls [28][29][30][31].…”

The pattern of incident fractures according to fracture site in people with T1D

“…Hence, BMD cannot solely explain the increased fracture burden in T1D. Newer studies have suggested that people with T1D may also have an increased bone fragility from decreased bone quality, which partly explains the increased risk of fractures [19][20][21].…”