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Risk Factors for Bone Microarchitecture Impairments in Older Men With Type 2 Diabetes-The MrOS Study.

Malak Faraj1, Ann V Schwartz2, Andrew J Burghardt3

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Older men with type 2 diabetes (T2DM) have smaller bone size, increasing fragility risk. Longer diabetes duration and insulin use further impact bone structure and strength.

Keywords:
bone microarchitecturebone strengthfracture riskhigh-resolution peripheral quantitative computed tomographytype 2 diabetes mellitus

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Area of Science:

  • Endocrinology
  • Bone Biology
  • Geriatrics

Background:

  • Impaired bone microarchitecture may contribute to bone fragility in type 2 diabetes (T2DM).
  • Data on the impact of T2DM on bone structure in men are limited.
  • High-resolution peripheral quantitative computed tomography (HR-pQCT) assesses bone microarchitecture.

Purpose of the Study:

  • To investigate the association between T2DM and HR-pQCT parameters in older men.
  • To explore how diabetes duration and insulin use affect bone parameters in T2DM.
  • To determine if specific bone parameters are linked to fracture risk in T2DM men.

Main Methods:

  • HR-pQCT scans analyzed in 1777 older men from the Osteoporotic Fractures in Men study.
  • T2DM status determined by self-report or medication use.
  • Linear regression models adjusted for covariates compared HR-pQCT parameters between T2DM and non-T2DM groups.

Main Results:

  • Men with T2DM exhibited smaller total cross-sectional and cortical areas in the tibia.
  • Trabecular indices and cortical porosity were similar between T2DM and non-T2DM groups.
  • Longer diabetes duration (≥10 years) associated with higher cortical porosity and trabecular thickness; insulin use linked to reduced cortical area/thickness and lower failure load.

Conclusions:

  • Older men with T2DM have reduced bone size, potentially contributing to skeletal fragility.
  • Longer diabetes duration is associated with increased cortical porosity.
  • Insulin use in T2DM men is linked to poorer bone structure and reduced bone strength, increasing fracture risk.