Peripheral quantitative computed tomography for the detection of diabetic osteopathy: a study in the Goto-Kakizaki...

To assess the utility of dual energy x-ray absorptiometry (DEXA) and peripheral quantitative computed tomography (pQCT) in detecting trabecular and cortical bone changes in diabetes as a model of osteopenia.

The tibia from 10 type-2 diabetic Goto-Kakizaki (GK) rats and 10 control Wistar rats were analyzed by DEXA, pQCT, and ash weight determination.

DEXA of GK rats showed a significant reduction in mineral content (32%) and density (24%) of the metaphysis, but not of the diaphysis. PQCT disclosed that the reduction of density predominantly pertained to the trabecular bone (reduced by 62%). Periosteal and endosteal circumferences of the diaphyses were increased and cortical thickness was unchanged leading to increased moment of inertia.

This study suggests that in osteopathic conditions, cortical and trabecular bone should be separately examined within specific subregions to obtain relevant information. Loss of metaphyseal trabecular bone seems to be a predominant feature in diabetic rats. Moreover, there is increased moment of inertia in the diaphysis implying increased strength. These diagnostic features of diabetic osteopathy can only be assessed by pQCT. It may prove that similar changes occur in human type-2 diabetes, which could explain the susceptibility to periarticular fracture and Charcot arthropathy.