Type 1 diabetes patients have lower strength in femoral bone determined by quantitative computed tomography: A cross‐sectional study

Ishikawa, Kentaro; Fukui, Tetsuya; Nagai, Takashi; Kuroda, Takeshi; Hara, Naoyuki; Yamamoto, Takakazu; Inagaki, Kenji; Hirano, Tsutomu

doi:10.1111/jdi.12372

Cited by 21 publications

(8 citation statements)

References 43 publications

(78 reference statements)

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“…Previous evidence regarding cortical microarchitecture in Asian T1D patients is lacking. Our results were consistent with those from the only previous study to demonstrate lower cortical CSA and thickness in young and middle-aged Japanese T1D adults [ 18 ]. Two studies conducted in a Western population with older age and longer disease duration also found similar results.…”

Section: Discussionsupporting

confidence: 93%

“…However, only one of these studies has focused on an Asian population, and that study had a very small sample size. In that cross-sectional study conducted among Japanese subjects, 17 young or middle-aged T1D patients were found to have significantly lower cortical thickness and cortical CSA in the femoral intertrochanter than 18 healthy control subjects [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

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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

Wang

et al. 2020

Endocrine

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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.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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

Wang

et al. 2020

Endocrine

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“…Few studies have addressed skeletal impairment in men with T1D, and these studies suggest that men experience a more marked bone affection than their female counterparts 14,15 . Men with T1D also have increased femoral neck fragility and decreased femoral strength assessed by QCT compared to controls 16,17 .The main objective of this study was therefore to assess bone quality by measurement of TBS and BMSi by IMI in men with T1D compared to healthy age-matched men. Moreover, we wanted to examine BMD, bone turnover, serum pentosidine, and the associations of TBS and BMSi with BMD, glycated hemoglobin (HbA 1c ), duration of disease, and daily insulin dosage.…”

Section: Introductionmentioning

confidence: 99%

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

Syversen

Mosti

Mynarek

et al. 2021

Endocrine Connections

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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.

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“…Therefore, the previous reports may have underestimated the effect of denosumab discontinuation. With QCT, bone strength can be evaluated and trabecular bone and cortical bone can be assessed separately in three dimensions, without the interference of the surrounding osteophytes 9,15,16. The magnitude of bone loss was greater in the femoral bone than in the LS, and the FN-BMD returned to the average baseline value.…”

Section: Discussionmentioning

confidence: 99%

<p>Analysis of three-dimensional bone mineral density and bone strength measured by quantitative computed tomography following denosumab discontinuation in a patient with postmenopausal osteoporosis</p>

Tsuchiya¹,

Ishikawa²,

Tani³

et al. 2019

CIA

Self Cite

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Discontinuation of denosumab during osteoporosis treatment leads to rapid loss of bone mineral density and induces a bone turnover rebound effect. Previous studies have reported analysis based on dual-energy X-ray absorptiometry scanning (DXA). Here, we report the first case involving analysis of three-dimensional bone mineral density and bone strength, measured by quantitative computed tomography (QCT) after discontinuation of denosumab. An 82-year-old woman who discontinued denosumab because of patient’s wish was administered the fifth dose after a gap of 14 months. Her bone mineral density evaluated by DXA and QCT, bone strength, and bone turnover marker levels showed significant rebound phenomenon. The levels of the cortical parameters of the hip were also decreased indicating an increased risk of femoral fractures after denosumab interruption. Our case highlights the increased risk of fractures after discontinuation of denosumab. Therefore, denosumab must be used judiciously without interruption in the dosage schedule.

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Type 1 diabetes patients have lower strength in femoral bone determined by quantitative computed tomography: A cross‐sectional study

Cited by 21 publications

References 43 publications

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

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

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

<p>Analysis of three-dimensional bone mineral density and bone strength measured by quantitative computed tomography following denosumab discontinuation in a patient with postmenopausal osteoporosis</p>

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