Observational Study

. 2018 Dec;29(12):2725-2738.

doi: 10.1007/s00198-018-4678-3. Epub 2018 Sep 13.

The association between diabetes status, HbA1c, diabetes duration, microvascular disease, and bone quality of the distal radius and tibia as measured with high-resolution peripheral quantitative computed tomography-The Maastricht Study

E A C de Waard^{1

2}, J J A de Jong^{3

4}, A Koster^{5

6}, H H C M Savelberg^{4

7}, T A van Geel^{5

8}, A J H M Houben^{9

10}, M T Schram^{9

10}, P C Dagnelie^{5

10

11}, C J van der Kallen^{9

10}, S J S Sep^{5

9

10

12}, C D A Stehouwer^{9

10}, N C Schaper^{5

9

10}, T T J M Berendschot¹³, J S A G Schouten¹³, P P M M Geusens^{5

14

15}, J P W van den Bergh^{4

14

16}

Affiliations

¹ Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University, Maastricht, the Netherlands. e.dewaard@maastrichtuniversity.nl.
² NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Universiteitssingel 40, room C5.535, P.O. Box 5800, 6202 AZ, Maastricht, the Netherlands. e.dewaard@maastrichtuniversity.nl.
³ Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University, Maastricht, the Netherlands.
⁴ NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Universiteitssingel 40, room C5.535, P.O. Box 5800, 6202 AZ, Maastricht, the Netherlands.
⁵ CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
⁶ Department of Social Medicine, Maastricht University, Maastricht, the Netherlands.
⁷ Department of Human Movement Science, Maastricht University, Maastricht, the Netherlands.
⁸ Department of Family Medicine, Maastricht University, Maastricht, the Netherlands.
⁹ Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.
¹⁰ CARIM School for Cardiovascular diseases, Maastricht University, Maastricht, the Netherlands.
¹¹ Department of Epidemiology, Maastricht University, Maastricht, the Netherlands.
¹² Department of Rehabilitation Medicine, Maastricht University, Maastricht, the Netherlands.
¹³ University Eye Clinic Maastricht, Maastricht, the Netherlands.
¹⁴ Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Centre, Maastricht, the Netherlands.
¹⁵ Biomedical Research Institute, University of Hasselt, Hasselt, Belgium.
¹⁶ Department of Internal Medicine, Subdivision of Endocrinology, VieCuri Medical Center, Venlo, the Netherlands.

PMID: 30209523
PMCID: PMC6267131
DOI: 10.1007/s00198-018-4678-3

Observational Study

The association between diabetes status, HbA1c, diabetes duration, microvascular disease, and bone quality of the distal radius and tibia as measured with high-resolution peripheral quantitative computed tomography-The Maastricht Study

E A C de Waard et al. Osteoporos Int. 2018 Dec.

. 2018 Dec;29(12):2725-2738.

doi: 10.1007/s00198-018-4678-3. Epub 2018 Sep 13.

Authors

Affiliations

¹ Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University, Maastricht, the Netherlands. e.dewaard@maastrichtuniversity.nl.
² NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Universiteitssingel 40, room C5.535, P.O. Box 5800, 6202 AZ, Maastricht, the Netherlands. e.dewaard@maastrichtuniversity.nl.
³ Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University, Maastricht, the Netherlands.
⁴ NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Universiteitssingel 40, room C5.535, P.O. Box 5800, 6202 AZ, Maastricht, the Netherlands.
⁵ CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
⁶ Department of Social Medicine, Maastricht University, Maastricht, the Netherlands.
⁷ Department of Human Movement Science, Maastricht University, Maastricht, the Netherlands.
⁸ Department of Family Medicine, Maastricht University, Maastricht, the Netherlands.
⁹ Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.
¹⁰ CARIM School for Cardiovascular diseases, Maastricht University, Maastricht, the Netherlands.
¹¹ Department of Epidemiology, Maastricht University, Maastricht, the Netherlands.
¹² Department of Rehabilitation Medicine, Maastricht University, Maastricht, the Netherlands.
¹³ University Eye Clinic Maastricht, Maastricht, the Netherlands.
¹⁴ Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Centre, Maastricht, the Netherlands.
¹⁵ Biomedical Research Institute, University of Hasselt, Hasselt, Belgium.
¹⁶ Department of Internal Medicine, Subdivision of Endocrinology, VieCuri Medical Center, Venlo, the Netherlands.

PMID: 30209523
PMCID: PMC6267131
DOI: 10.1007/s00198-018-4678-3

Abstract

In this small cross-sectional study of predominantly well-treated participants with relatively short-term type 2 diabetes duration, HbA1c > 7% (53 mmol/mol) was associated with lower cortical density and thickness and higher cortical porosity at the distal radius, lower trabecular thickness at the distal tibia, and higher trabecular number at both sites.

Introduction: To examine the association between diabetes status and volumetric bone mineral density (vBMD), bone microarchitecture and strength of the distal radius and tibia as assessed with HR-pQCT. Additionally-in participants with type 2 diabetes (T2DM), to examine the association between HbA1c, diabetes duration, and microvascular disease (MVD) and bone parameters.

Methods: Cross-sectional data from 410 (radius) and 198 (tibia) participants of The Maastricht Study (mean age 58 year, 51% female). Diabetes status (normal glucose metabolism, prediabetes, or T2DM) was based on an oral glucose tolerance test and medication history.

Results: After full adjustment, prediabetes and T2DM were not associated with vBMD, bone microarchitecture, and strength of the radius and tibia, except for lower trabecular number (Tb.N) of the tibia (- 4%) in prediabetes and smaller cross-sectional area of the tibia (- 7%) in T2DM. In T2DM, HbA1c > 7% was associated with lower cortical vBMD (- 5%), cortical thickness (- 16%), higher cortical porosity (+ 20%) and Tb.N (+ 9%) of the radius, and higher Tb.N (+ 9%) and lower trabecular thickness (- 13%) of the tibia. Diabetes duration > 5 years was associated with higher Tb.N (+ 6%) of the radius. The presence of MVD was not associated with any bone parameters.

Conclusions: In this study with predominantly well-treated T2DM participants with relatively short-term diabetes duration, inadequate blood glucose control was negatively associated with cortical bone measures of the radius. In contrast, trabecular number was increased at both sites. Studies of larger sample size are warranted for more detailed investigations of bone density and bone quality in patients with T2DM.

Keywords: Bone quality; Diabetes duration; Diabetes status; HbA1c; High-resolution peripheral quantitative computed tomography (HR-pQCT); Microvascular disease.

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References

1. Looker AC, Eberhardt MS, Saydah SH. Diabetes and fracture risk in older U.S. adults. Bone. 2016;82:9–15. doi: 10.1016/j.bone.2014.12.008. - DOI - PMC - PubMed
1. Leslie WD, Lix LM, Prior HJ, Derksen S, Metge C, O’Neil J. Biphasic fracture risk in diabetes: a population-based study. Bone. 2007;40(6):1595–1601. doi: 10.1016/j.bone.2007.02.021. - DOI - PubMed
1. de Liefde II, van der Klift M, de Laet CE, van Daele PL, Hofman A, Pols HA. Bone mineral density and fracture risk in type-2 diabetes mellitus: the Rotterdam Study. Osteoporos Int. 2005;16(12):1713–1720. doi: 10.1007/s00198-005-1909-1. - DOI - PubMed
1. Vestergaard P. Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes--a meta-analysis. Osteoporos Int. 2007;18(4):427–444. doi: 10.1007/s00198-006-0253-4. - DOI - PubMed
1. Janghorbani M, van Dam RM, Willett WC, Hu FB. Systematic review of type 1 and type 2 diabetes mellitus and risk of fracture. Am J Epidemiol. 2007;166(5):495–505. doi: 10.1093/aje/kwm106. - DOI - PubMed

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The association between diabetes status, HbA1c, diabetes duration, microvascular disease, and bone quality of the distal radius and tibia as measured with high-resolution peripheral quantitative computed tomography-The Maastricht Study

Affiliations

The association between diabetes status, HbA1c, diabetes duration, microvascular disease, and bone quality of the distal radius and tibia as measured with high-resolution peripheral quantitative computed tomography-The Maastricht Study

Authors

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Abstract

Conflict of interest statement

Conflicts of interest

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Cited by

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