Related Experiment Video
Updated: Feb 8, 2026

Author Spotlight: An Economic and Efficient Method for Quantitative Evaluation of Bone Microarchitecture in a Murine Osteoporosis Model
Published on: September 8, 2023
Type 2 diabetes is associated with higher trabecular bone density but lower cortical bone density: the Vietnam
L T Ho-Pham1, P M N Chau2, A T Do2
1Bone and Muscle Research Group & Faculty of Applied Sciences, Ton Duc Thang University, 19 Nguyen Huu Tho, Tan Phong, District 7, Ho Chi Minh City, 700000, Vietnam. hophamthuclan@tdt.edu.vn.
Abstract:
It is not clear why type 2 diabetes (T2D) has an increased risk of fracture despite higher areal bone mineral density. This study showed that compared with controls, T2D patients had higher trabecular bone density but lower cortical bone density, resulting in a lower bone strength.
Introduction:
To define the association between type 2 diabetes and bone architecture and measures of bone strength.
Methods:
The study was part of the Vietnam Osteoporosis Study, in which 1115 women and 614 men aged ≥ 30 were randomly recruited from Ho Chi Minh City. HbA1c levels were measured with analyzers ADAMS™ A1c HA-8160 (Arkray, Kyoto, Japan). The diagnosis of T2D was made if HbA1c was ≥ 6.5%. Trabecular and cortical volumetric bone density (vBMD) was measured in the forearm and leg by a pQCT XCT2000 (Stratec, Germany). Polar stress strain index (pSSI) was derived from the pQCT measurements. Difference in bone parameters between T2D and non-diabetic individuals was assessed by the number of standard deviations (effect size [ES]) by the propensity score analysis.
Results:
The prevalence of T2D was ~ 8%. The results of propensity score matching for age, sex, and body mass index in 137 pairs of diabetic and non-diabetic individuals showed that T2D patients had significantly higher distal radius trabecular vBMD (ES 0.26; 95% CI, 0.02 to 0.50), but lower cortical vBMD (ES - 0.22; - 0.46 to 0.00) and reduced pSSI (ES - 0.23; - 0.47 to - 0.02) compared with non-diabetic individuals. Multiple linear regression analysis based on the entire sample confirmed the results of the propensity score analysis.
Conclusion:
Compared with non-diabetic individuals, patients with T2D have greater trabecular but lower cortical vBMD which leads to lower bone strength.
Related Concept Videos
Diabetes Mellitus: Type 2 and Gestational
Density
Current Density
Strain-Energy Density
In the elastic region of a material, the relationship between the stress and the strain is linear and follows Hooke's Law. The strain energy density in this region...
Bulk Density of Aggregate
Most natural mineral aggregates, like sand and gravel,...
Density and Archimedes' Principle

