Profiling bone status indices reveals evidence of a low-turnover bone phenotype in type 2 diabetes: findings from the DiaFALL cohort
Authors' conclusion
T2D was characterized by higher aBMD together with broadly suppressed BSIs, consistent with a low-turnover skeletal phenotype not captured by DXA alone. Osteocalcin og sclerostin appeared most informative. These findings support longitudinal studies to determine whether BSIs can enhance identification of skeletal fragility in T2D.
Study context
- Population
- Adults with T2D and age- and sex-matched controls, DiaFALL cohortmatched 1:1
- Exposure
- T2D vs age- and sex-matched controls
- T2Dn = 105
- Outcome
- aBMD and bone status indices (BSIs)
Methodological detailsmatched, age- and sex-matched controls 1:1, exploratory sex-stratified analyses
- Matched
- Age- and sex-matched controls 1:1
- Exploratory sex-stratified analyses
Main finding
As reported in the abstract
Each group vs controlsEstimate (95% CI)P value
T2D
Δ i-PINP, men −12.8 µg/L(−19.4 to −6.2)
P = 0.002T2D
Δ i-PINP, women −13.6 µg/L(−25.9 to −1.3)
P = 0.002T2D
Δ osteocalcin, men −6.36 µg/L(−9.15 to −3.57)
P < 0.001T2D
Δ osteocalcin, women −6.66 µg/L(−11.0 to −2.20)
P < 0.001- T2D
- difference (femoral-neck areal bone mineral density (aBMD), men) + 0.070 g/cm² (95% CI + 0.026 to + 0.114); P = 0.002
- T2D
- difference (femoral-neck aBMD, women) + 0.089 (95% CI + 0.039 to + 0.139); P = 0.001
- T2D
- difference (lumbar-spine aBMD, women) + 0.137 g/cm² (95% CI + 0.072 to + 0.202); P < 0.001
- T2D
- Δ β-CTX-I, men −40.5 ng/L (95% CI −62 to −18); P = 0.012
- T2D
- Δ β-CTX-I, women −110 ng/L (95% CI −180 to −44); P = 0.014
- T2D
- Δ sclerostin, men + 24.6 pmol/L (95% CI + 1.5 to + 47.7); P = 0.019
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| Femoral-neck aBMDT2D (men) vs Controls (men) | difference + 0.070 g/cm² (95% CI + 0.026 to + 0.114) | P = 0.002 |
| Femoral-neck aBMDT2D (women) vs Controls (women) | difference + 0.089 (95% CI + 0.039 to + 0.139) | P = 0.001 |
| Lumbar-spine aBMD, womenT2D (women) vs Controls (women) | difference + 0.137 g/cm² (95% CI + 0.072 to + 0.202) | P < 0.001 |
| Sclerostin, menT2D (men) vs Controls (men) | Δ + 24.6 pmol/L (95% CI + 1.5 to + 47.7) | P = 0.019 |
- Sclerostin, men — Sclerostin correlated positively with lumbar-spine aBMD (r)
- 0.411; p = 0.007
T2D-sex interaction for Bone Status Indices (BSIs)
- No significant T2D-sex interactions for any BSI
- all p > 0.05
- Exploratory sex-stratified analyses
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Profiling bone status indices reveals evidence of a low-turnover bone phenotype in type 2 diabetes: findings from the DiaFALL cohort. Osteoporos Int. Published 21 January 2026. doi:10.
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