Microvascular disease and early diabetes onset are associated with deficits in femoral neck bone density and structure among older adults with longstanding type 1 diabetes
Authors' conclusion
In summary, among older adults with T1D, those who were diagnosed before the age of 15 yr, as well as those with nephropathy and neuropathy had unfavorable bone outcomes at the FN, which may contribute to the high risk of hip fractures among patients with T1D.
Study context
- Population
- Older adults with longstanding T1D and matched non-diabetic controls with abdominal or pelvis CT exams 2010–2020; 3D CT of proximal femur
- Participants
- 101 vs 181
- Exposure
- Older adults with longstanding T1D vs non-diabetic controls
- T1Dn = 101
- Controls (CON)n = 181reference
- Outcome
- Femoral neck (FN) density
Methodological detailsage-, sex-, and race-matched controls
- Age-, sex-, and race-matched controls
Main finding
As reported in the abstract
- Whole cohort: T1D tended to have lower FN density, differences not statistically significant
Observational data: associations, not effects.
Further findings
FN bone outcomes, T1D diagnosed before age 15 vs matched controls
- Lower total BMC (TtBMC)
- −14%
- Lower cortical BMC (CtBMC)
- −19.5%
- Smaller Ct cross-sectional area (CtCSA)
- −12.6
- p<.05 for all
FN bone outcomes, T1D diagnosed at a later age vs controls
- Did not differ from controls in any bone outcome
- P > 0.21
FN bone outcomes, T1D with nephropathy vs matched controls
- Lower FN aBMD
- −10.6%
- Lower TtBMC
- −17%
- Lower CtBMC
- −24%
- Smaller CtCSA
- −15.4%
- p<.05 for all
FN bone outcomes, T1D with neuropathy vs controls
- Cortical bone deficits
- 8.4%-12%, p<.04
Microvascular complications among T1D
- Mild-to-moderate nephropathy
- 33 (33%)
- Neuropathy
- 61 (60%)
- Retinopathy
- 71 (70%)
Original publication
Microvascular disease and early diabetes onset are associated with deficits in femoral neck bone density and structure among older adults with longstanding type 1 diabetes. J Bone Miner Res. Published 16 August 2024. doi:10.
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