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Bone Microarchitecture in Men and Women with Diabetes: The Importance of Cortical Porosity

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Abstract

High-resolution peripheral quantitative computed tomography (HR-pQCT) captures novel aspects of bone geometry, volumetric bone mineral density and offers the ability to measure bone microarchitecture, but data relating measures obtained from this technique to diabetic status are inconsistent in women and lacking in men. Here, we report an analysis from the Hertfordshire Cohort Study, where we were able to study associations between bone microarchitecture from HR-pQCT of distal radius and distal tibia in 332 participants (177 men and 155 women) aged 72.1–81.4 years with or without diabetes mellitus (DM); n = 29 (18 men and 11 women) and n = 303, respectively. Statistical analyses were performed separately for women and men. The mean (SD) age of participants was 76.4 (2.6) and 76.1 (2.5) years in women and men, respectively. Participants with DM differed significantly in terms of weight in both women (70.4 ± 12.3 vs. 80.3 ± 18.3 kg; p = 0.015) and men (81.7 ± 11.4 vs. 92.8 ± 16.3 kg; p < 0.001) but no differences were found in height, smoking status, alcohol intake, social class and physical activity among women or men. Analyses in women revealed that cortical pore volume (Ct.Po.V) was higher in participants with DM and close to statistical significance for cortical porosity (Ct.Po) (β = 0.76 [0.12, 1.41] z-score, p = 0.020 and β = 0.62 [−0.02, 1.27] z-score, p = 0.059, respectively) at the distal radius. Adjustment for weight did not materially affect the relationship described for Ct.Po.V (β = 0.74 [0.09, 1.39], p = 0.027) and Ct.Po (β = 0.65 [−0.01, 1.30], p = 0.053) at the distal radius. After adjustment for weight, analyses in men revealed that Ct.Po and Ct.Po.V were higher in participants with DM (β = 0.57 [0.09, 1.06] z-score, p = 0.021 and β = 0.48 [0.01, 0.95] z-score, p = 0.044, respectively) at the distal tibia. Analyses of distal radial and tibial trabecular bone parameters according to diabetic status revealed no significant differences among men or women after adjustment for weight. We found higher cortical porosity and cortical pore volume at the distal tibia in men with DM and higher cortical pore volume at the distal radius in women with a non-significant tendency for higher cortical porosity. The results of our study suggest that deficits in cortical bone exist both in older men and women with DM.

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Acknowledgments

This research has been made possible thanks to a fellowship grant from Arthritis Research UK (Grant Number 19583). The present work was funded by grants from servier and la Société Française de Rhumatologie. This research is funded by MRC (Programme Number U105960371).The Hertfordshire Cohort Study was supported by the Medical Research Council (MRC) of Great Britain; Arthritis Research UK; and the International Osteoporosis Foundation. The work herein was also supported by the NIHR Nutrition BRC, University of Southampton and the NIHR Musculoskeletal BRU, University of Oxford. KAW’s research is funded by MRC Programme number U105960371. Imaging was performed at MRC Human Nutrition Research, Cambridge. We thank all of the men and women who took part in the Hertfordshire Cohort Study; the HCS Research Staff; and Vanessa Cox who managed the data.

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Authors and Affiliations

  1. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK

    Julien Paccou, Karen A. Jameson, Elaine M. Dennison, Cyrus Cooper & Mark H. Edwards

  2. Elsie Widdowson Laboratory, MRC Human Nutrition Research, 120 Fulbourn Road, Cambridge, CB1 9NL, UK

    Kate A. Ward

  3. Victoria University, Wellington, New Zealand

    Elaine M. Dennison

  4. NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, OX3 5UG, UK

    Cyrus Cooper

  5. Faculty of Medicine, NIHR Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Trust, Southampton General Hospital, Southampton, SO16 6YD, UK

    Cyrus Cooper

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  1. Julien Paccou
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  2. Kate A. Ward
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  3. Karen A. Jameson
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  4. Elaine M. Dennison
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  5. Cyrus Cooper
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Correspondence to Cyrus Cooper.

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Conflict of Interest

Professor Cooper has received consultancy fees/honoraria from Servier; Eli Lilly; Merck; Amgen; Alliance; Novartis; Medtronic; GSK; Roche. Julien Paccou, Mark Edwards, Kate Ward, Karen Jameson, Charlotte Moss, Nicholas Harvey, and Elaine Dennison declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article contains studies with human subjects and all participants gave written informed consent in accordance with the Declaration of Helsinki. This studies did not include animals.

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Paccou, J., Ward, K.A., Jameson, K.A. et al. Bone Microarchitecture in Men and Women with Diabetes: The Importance of Cortical Porosity. Calcif Tissue Int 98, 465–473 (2016). https://doi.org/10.1007/s00223-015-0100-8

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  • DOI: https://doi.org/10.1007/s00223-015-0100-8

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