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Trabecular bone quality is lower in adults with type 1 diabetes and is negatively associated with insulin resistance

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Abstract

Summary

We evaluated trabecular bone score (TBS) and factors affecting TBS in adults with type 1 diabetes (T1D) compared to age-, sex-, and body mass index (BMI)-matched adults without diabetes. Adults with T1D had lower TBS compared to controls. Abdominal obesity and insulin resistance are associated with lower TBS.

Introduction

We evaluated TBS, a non-invasive method to evaluate trabecular bone quality at the lumbar spine, in adults with T1D compared to age-, sex-, and BMI-matched adults without diabetes.

Methods

We calculated TBS from adults with T1D (n = 47) and controls (n = 47) who had a lumbar spine dual x-ray absorptiometry (DXA) at their third visit (2006–2009) of the ongoing “Coronary Artery Calcification in Type 1 Diabetes (CACTI) Study.” The linear relationships of TBS and bone mineral density (BMD) with hemoglobin A1c, blood pressure, lipids, and insulin resistance were evaluated using Pearson’s correlation coefficient. Multiple linear regression was used to test the association of TBS with sex and diabetes while adjusting for other potential confounders.

Results

TBS was significantly lower in adults with T1D compared to controls (1.42 ± 0.12 vs 1.44 ± 0.08, p = 0.02) after adjusting for age, sex, current smoking status, and lumbar spine BMD, despite no difference in lumbar spine BMD between the groups. Components of the metabolic syndrome, including diastolic blood pressure, BMI, triglycerides, and insulin resistance were negatively correlated with TBS among patients with T1D.

Conclusion

Trabecular bone score, an indirect measurement of trabecular bone quality, was lower in adults with T1D compared to controls. Components of metabolic syndrome and insulin resistance were associated with lower TBS in adults with T1D.

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Acknowledgements

The study was supported from NHLBI grants HL61753, HL79611, and HL113029, DERC Clinical Investigation Core P30 DK57516, JDRF grant 17-2013-313, American Diabetes Association Career Development Award to Dr. Snell-Bergeon (7-13-CD-50) and a Center for Women’ Health Research Seed Grant to Dr. Shah. The study was performed at the Adult CTRC at UCD supported by NIH-M01-RR00051 and CTSA Grant UL1 TR001082 (IES), at the Barbara Davis Center for Childhood Diabetes and at Colorado Heart Imaging Center in Denver, CO.

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Authors and Affiliations

  1. Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    V. N. Shah, R. Sippl, P. Joshee, L. Pyle & J. K. Snell-Bergeon

  2. Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    L. Pyle

  3. Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    W. M. Kohrt

  4. Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA

    W. M. Kohrt & I. E. Schauer

  5. Endocrinology Section, Department of Medicine, Denver VA Medical Center, Denver, CO, USA

    W. M. Kohrt & I. E. Schauer

  6. Eastern Colorado Geriatrics Research, Education, and Clinical Center, Denver, CO, USA

    W. M. Kohrt & I. E. Schauer

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  1. V. N. Shah
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Corresponding author

Correspondence to V. N. Shah.

Ethics declarations

All subjects provided informed consent and the study was approved by the Colorado Multiple Institutional Review Board.

Conflict of interest

VNS, RS, PJ, LP, PJ, WMK, IES, and JKS declare no conflict of interest related to this work. JKS is the guarantor of this work.

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Shah, V.N., Sippl, R., Joshee, P. et al. Trabecular bone quality is lower in adults with type 1 diabetes and is negatively associated with insulin resistance. Osteoporos Int 29, 733–739 (2018). https://doi.org/10.1007/s00198-017-4353-0

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