Increased cortical porosity in type 2 diabetic postmenopausal women with fragility fractures

IntroductionDiabetic bone disease is characterized by an increased fracture risk which may be partly attributed to deficits in cortical bone quality such as higher cortical porosity. However, the temporal evolution of bone microarchitecture, strength, and particularly of cortical porosity in diabetic bone disease is still unknown. Here, we aimed to prospectively characterize the 5-year changes in bone microarchitecture, strength, and cortical porosity in type 2 diabetic (T2D) postmenopausal women with (DMFx) and without history of fragility fractures (DM) and to compare those to nondiabetic fracture free controls (Co) using high resolution peripheral quantitative computed tomography (HR-pQCT).MethodsThirty-two women underwent baseline HR-pQCT scanning of the ultradistal tibia and radius and a FU-scan 5 years later. Bone microarchitectural parameters, including cortical porosity, and bone strength estimates via µFEA were calculated for each timepoint and annualized. Linear regression models (adjusted for race and change in BMI) were used to compare the annualized percent changes in microarchitectural parameters between groups.ResultsAt baseline at the tibia, DMFx subjects exhibited the highest porosity of the three groups (66.3% greater Ct.Po, 71.9% higher Ct.Po.Volume than DM subjects, p < 0.022). Longitudinally, porosity increased significantly over time in all three groups and at similar annual rates, while DMFx exhibited the greatest annual decreases in bone strength indices (compared to DM 4.7× and 6.7× greater decreases in failure load [F] and stiffness [K], p < 0.025; compared to Co 14.1× and 22.2× greater decreases in F and K, p < 0.020).ConclusionOur data suggest that despite different baseline levels in cortical porosity, T2D women with and without fractures experienced long-term porosity increases at a rate similar to non-diabetics. However, the annual loss in bone strength was greatest in T2D women with a history of a fragility fractures. This suggests a potentially non-linear course of cortical porosity development in T2D bone disease: major porosity may develop early in the course of disease, followed by a smaller steady annual increase in porosity which in turn can still have a detrimental effect on bone strength—depending on the amount of early cortical pre-damage.

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Volumetric femoral BMD, bone geometry, and serum sclerostin levels differ between type 2 diabetic postmenopausal women with and without fragility fractures

Osteoporosis International ◽

10.1007/s00198-014-2988-7 ◽

2015 ◽

Vol 26 (4) ◽

pp. 1283-1293 ◽

Cited By ~ 36

Author(s):

U. Heilmeier ◽

D. R. Carpenter ◽

J. M. Patsch ◽

R. Harnish ◽

G. B. Joseph ◽

...

Keyword(s):

Postmenopausal Women ◽

Bone Geometry ◽

Fragility Fractures ◽

Type 2 Diabetic

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Comparison of Bone Mineral Density, T-Scores and Serum Zinc between Diabetic and Non Diabetic Postmenopausal Women with Osteoporosis

Journal of Laboratory Physicians ◽

10.4103/0974-2727.151681 ◽

2015 ◽

Vol 7 (01) ◽

pp. 043-048 ◽

Cited By ~ 7

Author(s):

Priyanka R Siddapur ◽

Anuradha B Patil ◽

Varsha S Borde

Keyword(s):

Bone Mineral Density ◽

Fracture Risk ◽

Postmenopausal Women ◽

Bone Mineral ◽

Mineral Density ◽

T Score ◽

Increased Risk ◽

Serum Zn ◽

Type 2 Diabetic

ABSTRACT Context: Postmenopausal osteoporosis is a public health problem. Diabetics are at increased risk of osteoporosis-related fractures. Zinc (Zn) has a role in collagen metabolism, and its levels are altered in diabetes. Aims: The aim was to compare bone mineral density (BMD), T-score and serum Zn between diabetic and nondiabetic postmenopausal women with osteoporosis to see if they influence increased fracture risk in diabetes. Settings and Design: It is a cross-sectional study conducted at Department of Biochemistry, Jawaharlal Nehru Medical College, Belgaum. Materials and Methods: Thirty type 2 diabetic and 30 age-matched (aged 45-75 years) nondiabetic Dual energy X-ray absorptiometry (DEXA) confirmed postmenopausal osteoporotics were included from January 2011 to March 2012. Serum Zn was analyzed by atomic absorption spectrophotometry. Statistical Analysis Used: Mean and standard deviation of the parameters of the two groups were computed and compared by unpaired Student's t-test. Relationship between variables was measured by Karl Pearson's correlation co-efficient. A statistical significance is set at 5% level of significance (P < 0.05). Results: T-score was significantly higher in diabetics compared with nondiabetics(−2.84 ± 0.42 vs. −3.22 ± 0.74) P < 0.05. BMD and serum Zn of diabetics showed a significant positive correlation with body mass index (BMI). Conclusions: Type 2 diabetic postmenopausal osteoporotics have a higher T-score than the nondiabetics. High BMI in type-2 diabetes mellitus (T2DM) may contribute to high BMD and may be a protective factor against zincuria. Increased fracture risk in T2DM could be due to other factors like poor bone quality due to hyperglycemia rather than BMD. Strict glycemic control is of paramount importance.

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Evaluation of Bone Density Measurement in Type 2 Diabetic Postmenopausal Women with Hypertension and Hyperlipidemia

Journal of Menopausal Medicine ◽

10.6118/jmm.2015.21.1.36 ◽

2015 ◽

Vol 21 (1) ◽

pp. 36 ◽

Cited By ~ 6

Author(s):

Emel Kiyak Caglayan ◽

Yaprak Engin-Ustun ◽

Nagihan Sari ◽

Seyhan Karacavus ◽

Levent Seckin ◽

...

Keyword(s):

Bone Density ◽

Postmenopausal Women ◽

Density Measurement ◽

Bone Density Measurement ◽

Type 2 Diabetic

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Associations of polymorphisms in the gene promoters of cytokines and matrix metalloproteinases with bone mineral density in postmenopausal type 2 diabetic women

Diabetes Mellitus ◽

10.14341/dm8825 ◽

2018 ◽

Vol 21 (1) ◽

pp. 26-33

Author(s):

Olga N. Fazullina ◽

Vadim V. Klimontov ◽

Vladimir I. Konenkov ◽

Alla V. Shevchenko ◽

Viktor F. Prokoviev ◽

...

Keyword(s):

Bone Mineral Density ◽

Type 2 Diabetes ◽

Matrix Metalloproteinases ◽

Postmenopausal Women ◽

Bone Mineral ◽

Additive Model ◽

Gene Promoters ◽

Mineral Density ◽

Type 2 Diabetic

Background. Osteoporosis and type 2 diabetes are common comorbidities in postmenopausal women. An important role in the bone remodeling over the menopausal transition can be played by cytokines and matrix metalloproteinases (MMPs). It was shown that allelic variants in polymorphic positions of the genes of cytokines and MMPs affect the expression of these molecules under normal and pathological conditions. Aims. To examine associations between polymorphisms in the gene promoters of cytokines (TNFA, IL1B, IL4, IL6, IL10, VEGFA) and MMPs (MMP2, MMP3, MMP9) with bone mineral density (BMD) in postmenopausal women with type 2 diabetes. Materials and methods. We studied 197 Caucasian diabetic women, from 50 to70 years of age. An examination of BMD in the spine, proximal femur and forearm was performed by DEXA. Thirteen polymorphisms in the promoters of TNFA: -238 A/G (rs361525), -308 A/G(rs1800629) and -863 C/A (rs1800630), IL1B: -31 C/T (rs1143627), IL4: -590 C/T (rs2243250), IL6: -174 C/G (rs1800795), IL10: -592 C/A (rs1800872) and -1082 A/G (rs1800896), VEGFA: -2578 C/A (rs699947) and +936 C/T (rs3025039), MMP2: -1306 C/T (rs243865), MMP3: -1171 5A/6A (rs3025058) and MMP9: -1562 C/T (rs3918242), were investigated. Results. Seventy-three women had normal BMD, in 90 ones we revealed osteopenia, and 34 women had osteoporosis. Age, BMI and smoking were strongest predictors of BMD in multivariate regression analysis (p0.0001, p=0.003 and p=0.01, respectively). In the additive model, C allele and CC genotype in MMP9 -1562 position were associated with low BMD (OR 2.16, p=0.0007 and OR 2.02, p=0.0008, respectively). Association of the polymorphism with BMD remained significant after adjustment for clinical risk factors (p0.001). Twelve combinations of genotypes, associated positively with low BMD, were revealed by bioinformatic analysis (all p0.005). The СС genotype in position -1562 of MMP9, CC genotype in position -863 of TNFA, GG genotype in position -308 of TNFA, and AA genotype in position -1082 of IL10 were the most prevalent variants in these combinations. Conclusions. Variability in the gene promoters of cytokines and MMPs may confer individual susceptibility to osteoporosis in postmenopausal type 2 diabetic women.

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Bone mineral density in type 2 diabetic postmenopausal women

Bone ◽

10.1016/j.bone.2010.04.436 ◽

2010 ◽

Vol 47 ◽

pp. S185

Author(s):

E. Reunova ◽

A. Shepelkevich ◽

O. Baranova ◽

N. Vasilieva

Keyword(s):

Bone Mineral Density ◽

Postmenopausal Women ◽

Bone Mineral ◽

Mineral Density ◽

Type 2 Diabetic

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Impact of hormone replacement therapy on microvascular function in healthy and Type 2 diabetic postmenopausal women

Diabetic Medicine ◽

10.1111/j.1464-5491.2005.01456.x ◽

2005 ◽

Vol 22 (5) ◽

pp. 536-542 ◽

Cited By ~ 9

Author(s):

K. M. Gooding ◽

K. M. MacLeod ◽

G. Spyer ◽

P. Ewings ◽

J. E. Tooke ◽

...

Keyword(s):

Hormone Replacement Therapy ◽

Replacement Therapy ◽

Postmenopausal Women ◽

Hormone Replacement ◽

Microvascular Function ◽

Type 2 Diabetic

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Study of bone turnover markers, procollagen type 1 N-terminal propeptide and osteocalcin in healthy and type 2 diabetes mellitus postmenopausal women

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20203041 ◽

2020 ◽

Vol 8 (8) ◽

pp. 2839

Author(s):

G. G. Kaushik ◽

Rajesh Chahar ◽

Subhash Chandra

Keyword(s):

Diabetes Mellitus ◽

Bone Turnover ◽

Postmenopausal Women ◽

Bone Turnover Markers ◽

Diabetic Group ◽

Procollagen Type ◽

Turnover Markers ◽

Type 2 Diabetic

Background: Individuals with diabetes mellitus are at increased risk of metabolic bone disease due to decrease in bone strength and quality. Several bone turnover markers like serum procollagen type I N propeptide (P1NP) and serum osteocalcin are powerful tools for studying osteoporosis and fracture risk across population to provide diagnostic and prognostic information of bone health. The aim of this study was to recognize possible correlation of levels of serum P1NP and osteocalcin in type-2 diabetic (T2DM) postmenopausal women as compared to healthy postmenopausal women.Methods: The study included 100 proven cases of type-2 diabetic postmenopausal women with age matched healthy postmenopausal women as controls. P1NP, osteocalcin, and other relevant parameters were measured. Differences between diabetics and controls were analyzed.Results: The body mass index was higher in diabetic group as compared to controls. The HbA1c% was (6.94±1.43) in diabetic group and (5.57±1.21) in non-diabetics. Low serum level of 25 (OH) D was observed both in diabetic and non-diabetic groups but significantly lower in T2DM. Procollagen type 1 N propeptide was lower in diabetic group (37.59±17.20 ng/mL) as compared to non-diabetic (52.14±24.82 ng/mL). Osteocalcin was lower (15.64±8.06 ng/ml) as compared to non-diabetic group (21.85±9.12 ng/ml). Lower osteocalcin and P1NP levels found in this study suggests slower bone metabolism with reduced bone formation in postmenopausal diabetics.Conclusions: Serum procollagen type 1 N propeptide and osteocalcin in postmenopausal diabetic women were lower as compared to non-diabetic group.

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