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Bone structure and turnover in type 2 diabetes mellitus
1Department of Medicine, Division of Endocrinology, Metabolic Bone Diseases Unit, College of Physicians and Surgeons, Columbia University, 630 W. 168th St, New York, NY 10032, USA.
Summary
Postmenopausal women with type 2 diabetes (T2DM) show no differences in bone structure despite increased fracture risk. Lower bone formation markers, including P1NP and osteocalcin, suggest altered bone turnover in T2DM.
Area of Science:
- Endocrinology
- Metabolic Bone Disease
- Geriatric Medicine
Background:
- Type 2 diabetes (T2DM) is paradoxically linked to higher bone density but increased fracture risk.
- Investigating skeletal parameters in T2DM is crucial for understanding this discrepancy.
Purpose of the Study:
- To compare detailed skeletal parameters between postmenopausal women with and without T2DM.
- To explore potential explanations for the increased fracture risk in T2DM despite higher DXA-measured bone density.
Main Methods:
- A cross-sectional study comparing 25 postmenopausal women with T2DM and 25 matched controls.
- Utilized dual-energy X-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HR-pQCT), and biochemical bone turnover markers.
Main Results:
- No significant differences in bone structure were observed between T2DM and control groups via DXA and HR-pQCT.
- A trend towards lower cortical area at the tibia was noted in T2DM women (p=0.06).
- Significantly lower levels of bone formation markers, procollagen type 1 amino-terminal propeptide (P1NP) and osteocalcin, were found in T2DM patients.
Conclusions:
- Postmenopausal women with T2DM exhibit lower bone formation marker levels.
- Bone structure appears largely unaltered, with a potential minor reduction in tibial cortical bone.
- Reduced bone turnover may be a key skeletal characteristic contributing to fracture risk in T2DM.
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