Evidence of impaired bone quality in men with type 1 diabetes: a cross-sectional study

Abstract

Objective: Type 1 diabetes (T1D) is associated with a substantial fracture risk. Bone mineral density (BMD) is, however, only modestly reduced, suggesting impaired bone microarchitecture and/or bone material properties. Yet, the skeletal abnormalities have, however, not been uncovered. Men with TID seem to experience a more pronounced bone loss than their female counterparts. Hence, we aimed to examine different aspects of bone quality in men with T1D. Design and Methods: In this cross-sectional study, men with T1D and healthy, male controls were enrolled. BMD (femoral neck, total hip, lumbar spine, whole body), and spine trabecular bone score (TBS) were measured by dual x-ray absorptiometry, and bone material strength index (BMSi) by in vivo impact microindentation. HbA1c and bone turnover markers were analyzed. Results: Altogether, 33 men with T1D (43 ± 12 yrs) and 28 healthy male controls (42 ± 12 yrs) were included. Subjects with T1D exhibited lower whole body BMD than controls (p=0.04). TBS and BMSi were attenuated in men with T1D vs. controls (p=0.016 and p=0.004, respectively), and T1D subjects also had lower bone turnover. vs. controls. The bone parameters did not differ between subjects with or without diabetic complications. Duration of disease correlated negatively with femoral neck BMD, but not with TBS or BMSi. Conclusions: This study revealed compromised bone material strength and microarchitecture in men with T1D. Moreover, we confirm previous studies showing a modest decrease in BMD and low bone turnover in subjects with T1D, underscoring that bone should be recognized as a target of diabetic complications.

Bone Microarchitecture and Strength in Long-Standing Type 1 Diabetes

“…( 52 ) However, a recent study reported a less than 5% decrease in the median of bone material strength index (BMSi) measured with a reference point indenter (OsteoProbe) in a small cohort of males with T1DM compared to controls. ( 53 ) Interestingly, this finding is consistent with the reduction of cortical vBMD observed in our cohort with long‐standing T1DM. If the observed decrease in tissue material properties that constitute a necessary input for hFE analysis was confirmed, it would imply an overestimation of bone strength for the T1DM group by a similar amount of about 5%.…”

Chrysin Attenuates High Glucose-Induced BMSC Dysfunction via the Activation of the PI3K/AKT/Nrf2 Signaling Pathway

“…BMSCs were seeded on 24-well plates at a density of 2.5×10 4 were randomly divided into different groups. After 21 days of osteogenic induction, BMSCs were washed three times with PBS, fixed with 4% paraformaldehyde for 30 min, and incubated with Alizarin Red S (ARS) solution (Beyotime) for 10 min.…”

“… 2 , 3 Compared with nondiabetic individuals, patients with T1DM exhibit lower whole-body bone mineral density, poorer bone mechanical strength, and a higher risk of osteoporosis and fracture. 3 , 4 Moreover, the decreased bone turnover and osteopenia in T1DM patients often result in impaired bone regeneration, making bone repair in these patients challenging. 5 The establishment of novel treatment regimens to improve bone formation under T1DM conditions is a matter of pressing concern.…”

Associations between bone material strength index and FRAX scores

“…In an earlier study in this cohort, we reported that BMSi discriminates prior fracture and parental fracture [25]. Studies have also shown that mean BMSi is lower in groups with comorbidities known to affect fracture risk, such as, individuals with diabetes [31][32][33][34][35][36][37] or chronic kidney disease [38], and for those exposed to glucocorticoids [39].…”