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Bone structure and turnover in type 2 diabetes mellitus

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Abstract

Summary

We compared skeletal parameters in type 2 diabetic (T2DM) and non-diabetic postmenopausal women. Bone structure by dual energy x-ray absorptiometry (DXA) and HR-pQCT was not different, although procollagen type 1 amino-terminal propeptide (P1NP) and osteocalcin levels were lower in T2DM.

Introduction

T2DM is associated with increased fracture risk, but, paradoxically, with higher cross-sectional bone density (BMD) as measured by DXA. We sought explanations to this puzzle by investigating detailed structural and biochemical skeletal parameters in T2DM.

Methods

Cross-sectional comparison of 25 postmenopausal T2DM women and 25 matched controls using DXA, high-resolution peripheral quantitative computed tomography (HR-pQCT) and biochemical bone turnover markers.

Results

BMD by DXA did not differ between T2DM and controls. HR-pQCT assessment also did not differ, with the exception of cortical area at the tibia, which tended to be lower in the diabetics (difference of 12 ± 6 [mean ± SD] mm, p = 0.06). P1NP and osteocalcin levels were lower in T2DM as compared to controls (P1NP, 34.3 ± 16 vs. 57.3 ± 28 ng/ml; p = 0.005; osteocalcin, 4.5 ± 2 vs. 6.2 ± 2 nmol/L; p = 0.001).

Conclusions

Postmenopausal women with T2DM had lower levels of bone formation markers as compared to controls. Aside from a possible decrease in cortical bone area at a weight-bearing site, bone structure was not altered in T2DM. Lower bone turnover may be a skeletal parameter that is present in T2DM.

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Acknowledgment

Irving Institute for Clinical and Translational Research CTSA/CTO pilot award, NIH AR055968, NIH AI065200-05

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Authors and Affiliations

  1. Department of Medicine, Division of Endocrinology, Metabolic Bone Diseases Unit, College of Physicians and Surgeons, Columbia University, 630 W. 168th St, New York, NY, 10032, USA

    A. Shu, M. T. Yin, E. Stein, S. Cremers, E. Dworakowski, R. Ives & M. R. Rubin

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  1. A. Shu
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  2. M. T. Yin
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  3. E. Stein
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  4. S. Cremers
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  7. M. R. Rubin
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Correspondence to M. R. Rubin.

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Shu, A., Yin, M.T., Stein, E. et al. Bone structure and turnover in type 2 diabetes mellitus. Osteoporos Int 23, 635–641 (2012). https://doi.org/10.1007/s00198-011-1595-0

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