Title Do patients with type 2 diabetes have impaired hip bone microstructure? A study using 3D modeling of hip dual-energy X-ray absorptiometry
Authors Ubago-Guisado, Esther , Moratalla-Aranda, Enrique , Gonzalez-Salvatierra, Sheila , GIL COSANO, JOSÉ JUAN, Garcia-Fontana, Beatriz , Garcia-Fontana, Cristina , Gracia-Marco, Luis , Munoz-Torres, Manuel
External publication No
Means Front Endocrinol (Lausanne)
Scope Article
Nature Científica
JCR Quartile 1
SJR Quartile 1
Web https://www.scopus.com/inward/record.uri?eid=2-s2.0-85146838520&doi=10.3389%2ffendo.2022.1069224&partnerID=40&md5=981e5dd379391f85b840d07a1abf37fd
Publication date 09/01/2023
ISI 000916785300001
Scopus Id 2-s2.0-85146838520
DOI 10.3389/fendo.2022.1069224
Abstract AimPatients with type 2 diabetes (T2DM) have more risk of bone fractures. However, areal bone mineral density (aBMD) by conventional dual-energy x-ray absorptiometry (DXA) is not useful for identifying this risk. This study aims to evaluate 3D-DXA parameters determining the cortical and trabecular compartments in patients with T2DM compared to non-diabetic subjects and to identify their determinants. Materials and methodsCase-control study in 111 T2DM patients (65.4 +/- 7.6 years old) and 134 non-diabetic controls (64.7 +/- 8.6-year-old). DXA, 3D-DXA modelling via 3D-Shaper software and trabecular bone score (TBS) were used to obtain aBMD, cortical and trabecular parameters, and lumbar spine microarchitecture, respectively. In addition, biochemical markers as 25-hydroxyvitamin d, type I procollagen N-terminal propeptide (P1NP), C-terminal telopeptide of type I collagen (CTX), and glycated haemoglobin (HbA1c) were analysed. ResultsMean-adjusted values showed higher aBMD (5.4%-7.7%, ES: 0.33-0.53) and 3D-DXA parameters (4.1%-10.3%, ES: 0.42-0.68) in the T2DM group compared with the control group. However, TBS was lower in the T2DM group compared to the control group (-14.7%, ES: 1.18). In addition, sex (beta = 0.272 to 0.316) and body mass index (BMI) (beta = 0.236 to 0.455) were the most consistent and positive predictors of aBMD (p <= 0.01). BMI and P1NP were negative predictors of TBS (beta = -0.530 and -0.254, respectively, p <= 0.01), while CTX was a positive one (beta = 0.226, p=0.02). Finally, BMI was consistently the strongest positive predictor of 3D-DXA parameters (beta = 0.240 to 0.442, p<0.05). ConclusionPatients with T2DM present higher bone mass measured both by conventional DXA and 3D-DXA, suggesting that 3D-DXA technology is not capable of identifying alterations in bone structure in this population. Moreover, BMI was the most consistent determinant in all bone outcomes.
Keywords type 2 diabetes mellitus; 3D-DXA; bone modelling; bone remodeling; bone QCT; microCT
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