Fractures in women with type 2 diabetes are associated with marked deficits in cortical parameters and trabecular plates
Authors' conclusion
In summary, T2DM is associated with increased cortical porosity while those with T2DM and fracture have more marked cortical deficits and fewer trabecular plates associated with lower failure load.
Study context
- Population
- Multi-ethnic population-based sample of women, with and without T2D
- Participants
- 565 participants
- Exposure
- Women with T2D with vs without fracture; T2D vs controls
- T2Dn = 175
- Fracturen = 59
- No fracturen = 103reference
- Outcome
- Bone parameters in T2D with vs without adult atraumatic fracture
Methodological detailsmulti-ethnic, second-generation HRpQCT, individual trabecula segmentation and mineralization (ITS; ITM)
- Multi-ethnic
- Second-generation HRpQCT
- Individual trabecula segmentation and mineralization (ITS; ITM)
Main finding
As reported in the abstract
- Fracture (n = 59) vs no fracture (n = 103): lower adjusted aBMD at all sites by DXA
- 5.2%-8.5%
- Fracture: smaller cortical area by HRpQCT (all p<.05)
- 10.2%-16.1%
- Fracture: lower cortical thickness (all p<.05)
- 10.5-15.8%
- Fracture: lower failure load at radius and tibia, respectively (all p<.05)
- 18.1 and 17.2%
- Fracture: lower plate volume and thickness, respectively (p<.05)
- 5.7% and 4.7%
- Fracture: higher rod volume fraction, tibia only
- 12.8%
Observational data: associations, not effects.
Further findings
T2D vs controls, bone parameters
- Higher covariate-adjusted aBMD at all sites in T2D vs controls (all p<.005)
- 3.0%-6.5%
- Higher adjusted trabecular vBMD in T2D (HRpQCT)
- 5.3%-6.4%
- Higher adjusted trabecular number in T2D
- 3.8%-5.1%
- Higher adjusted cortical porosity at tibia only in T2D vs controls
- 10.0%
- Greater cortical area at radius and tibia in T2D
- Failure load did not differ
SGLT2i users (n = 19)
- Tended to have lower radial rod tissue mineral density by ITS
- P = 0.06
GLP-1 RA users (n = 19)
- Trabecular deficits at both sites, higher cortical porosity and larger pores at distal tibia
Original publication
Fractures in women with type 2 diabetes are associated with marked deficits in cortical parameters and trabecular plates. J Bone Miner Res. Published 11 June 2024. doi:10.
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