Bone remodeling and responsiveness to mechanical stimuli in individuals with type 1 diabetes mellitus
Authors' conclusion
Our findings represent in vivo evidence suggesting that bone remodeling in individuals with T1DM is in a state of low responsiveness to mechanical stimuli, resulting in impaired bone formation and resorption rates; these correlate to the degree of neuropathy and level of diabetes control.
Study context
- Population
- Consenting participants with T1D and varying degree of distal symmetric sensorimotor polyneuropathy, and controls, assessed at baseline and 4-yr follow-up
- Participants
- 20 vs 9
- Exposure
- T1D vs controls
- T1DMn = 20
- Controls (CTRL)n = 9reference
- Outcome
- Trabecular bone formation (Tb.F) and resorption (Tb.R), distal radius
- Follow-up
- 4-yr
Methodological details4-yr follow-up, longitudinal high-resolution peripheral quantitative-computed tomography (HR-pQCT) with 3D rigid image registration, micro-finite element analysis, Nerve conduction tested with DPNCheck in T1DM participants, HR-pQCT (82 μm) at standard distal sites
- 4-yr follow-up
- Longitudinal HR-pQCT with 3D rigid image registration
- Micro-finite element analysis
- Nerve conduction tested with DPNCheck in T1DM participants
- HR-pQCT (82 μm) at standard distal sites
Main finding
As reported in the abstract
Tb.F, relative difference
47%
P < 0.05
T1DM
Tb.R, relative difference
59%
P < 0.05
T1DM
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| Mechanoregulation: odds of formation (ORF) and resorption (ORR) with increasing/decreasing strainT1DM vs CTRL · lower with T1DM | ORF, relative difference 34% | P < 0.05 |
| Mechanoregulation: odds of formation (ORF) and resorption (ORR) with increasing/decreasing strainT1DM vs CTRL · lower with T1DM | ORR, relative difference 18% | P < 0.05 |
Correlates of Tb.F in T1DM
- Tb.F vs nerve conduction amplitude (positive correlation), P < .05
- R = 0.69
- Tb.F vs HbA1c (negative correlation), P < .05
- R = −0.45
Original publication
Bone remodeling and responsiveness to mechanical stimuli in individuals with type 1 diabetes mellitus. J Bone Miner Res. Published 4 January 2024. doi:10.
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