Osteoporosis International

, Volume 23, Issue 2, pp 635–641

Bone structure and turnover in type 2 diabetes mellitus

  • A. Shu
  • M. T. Yin
  • E. Stein
  • S. Cremers
  • E. Dworakowski
  • R. Ives
  • M. R. Rubin
Original Article

DOI: 10.1007/s00198-011-1595-0

Cite this article as:
Shu, A., Yin, M.T., Stein, E. et al. Osteoporos Int (2012) 23: 635. doi:10.1007/s00198-011-1595-0

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.

Keywords

Bone quality HR-pQCT Osteocalcin P1NP Type 2 diabetes mellitus 

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2011

Authors and Affiliations

  • A. Shu
    • 1
  • M. T. Yin
    • 1
  • E. Stein
    • 1
  • S. Cremers
    • 1
  • E. Dworakowski
    • 1
  • R. Ives
    • 1
  • M. R. Rubin
    • 1
  1. 1.Department of Medicine, Division of Endocrinology, Metabolic Bone Diseases Unit, College of Physicians and SurgeonsColumbia UniversityNew YorkUSA

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