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Assessment of bone quality in patients with diabetes mellitus

Osteoporosis International volume 29, pages 1721–1736 (2018)Cite this article

Abstract

Substantial evidence exists that diabetes mellitus is associated with an increased risk of osteoporotic fractures. Low bone strength as well as bone extrinsic factors are probably contributing to the increased bone fragility in diabetes. Bone density and quality are important determinants of bone strength. Although bone mineral density (BMD) and the fracture risk assessment tool (FRAX) are very useful clinical tools in assessing bone strength, they may underestimate the fracture risk in diabetes mellitus. Through advances in new technologies such as trabecular bone score (TBS) and peripheral quantitative computed tomography (pQCT), we can better assess the bone quality and fracture risk of patients with diabetes mellitus. Invasive assessments such as microindentation and histomorphometry have been great complement to the existing bone analysis techniques. Bone turnover markers have been found to be altered in diabetes mellitus patients and may be associated with fractures. This review will give a brief summary of the current development and clinical uses of these assessments.

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Acknowledgments

This study was supported by a grant from The Ministry of Science and Technology of the Peoples Republic of China (National Science and Technology Major Projects for Major New Drugs Innovation and Development 2008ZX09312-016), National Natural Science Foundation of China (No. 81070687,81170805 and 81670714), Beijing Natural Science Foundation (No. 7121012) and Scientific Research Foundation of Beijing Medical Development (No. 2007-3029), National Key Program of Clinical Science (WBYZ2011-873), CAMS Innovation Fund for Medical Sciences (No. 2016-I2M-3-003).

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  1. Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Wangfujing, Dongcheng District, Beijing, 100730, China

    N. Jiang & W. Xia

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Jiang, N., Xia, W. Assessment of bone quality in patients with diabetes mellitus. Osteoporos Int 29, 1721–1736 (2018). https://doi.org/10.1007/s00198-018-4532-7

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Keywords

  • Bone quality
  • Diabetes mellitus
  • Osteoporosis
  • Quantitative computed tomography
  • Trabecular bone score