Increased Advanced Glycation Endproducts, Stiffness, and Hardness in Iliac Crest Bone From Postmenopausal Women With Type 2 Diabetes Mellitus on Insulin
Authors' conclusion
These relationships suggest a potential mechanism by which bone fragility may increase despite greater tissue stiffness and hardness in individuals with T2DM; our results suggest that it occurs in the transition from IGT to overt T2DM.
Study context
- Population
- Postmenopausal women with normal glucose tolerance (NGT), IGT or T2D on insulin; iliac crest bone samplesnanoindentation/Raman subset 14 NGT, 14 T2DM
- Participants
- 35 / 26 / 25
- Exposure
- T2DM on insulin vs IGT vs NGT
- NGTn = 35reference
- IGTn = 26
- T2DMn = 25
- Outcome
- Bone AGE content (pentosidine by HPLC; fluorescent AGE density by multiphoton microscopy), composition and mechanical properties of iliac bone
Main finding
As reported in the abstract
- T2DM vs IGT
- difference in cortical pentosidine +24%; P = 0.087
- T2DM vs IGT
- difference in trabecular pentosidine +35%; P = 0.007
- T2DM vs NGT
- difference in cortical pentosidine +40%; P = 0.003
- T2DM vs NGT
- difference in trabecular pentosidine +35%; P = 0.004
- T2DM vs NGT
- difference in cortical fAGE cross-link density +71%; P < 0.001
- T2DM vs NGT
- difference in trabecular fAGE cross-link density +44%; P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| Cortical bone pentosidine, T2DM on metformin vs not on metformin | difference −35% | P = 0.017 |
| Cortical bone stiffness and hardness (nanoindentation subset)T2DM vs NGT | difference in stiffness +9% | P = 0.021 |
| Cortical bone stiffness and hardness (nanoindentation subset)T2DM vs NGT | difference in hardness +8% | P = 0.039 |
Association of bone advanced glycation endproduct (AGEs) with HbA1c
- Pentosidine vs HbA1c
- R2 = 0.28, p < 0.001
- fAGE density vs HbA1c
- R2 = 0.30, p < 0.001
Original publication
Increased Advanced Glycation Endproducts, Stiffness, and Hardness in Iliac Crest Bone From Postmenopausal Women With Type 2 Diabetes Mellitus on Insulin. J Bone Miner Res. Published 8 December 2022. doi:10.
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