Cortical bone laminar analysis reveals increased midcortical and periosteal porosity in type 2 diabetic postmenopausal women with history of fragility fractures compared to fracture-free diabetics

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.

Download Full-text

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

Download Full-text

Objectivization of vacuum-compression therapy effects on micro- and macrovascular perfusion in type 2 diabetic patients

Biomedical Engineering / Biomedizinische Technik ◽

10.1515/bmt-2019-0066 ◽

2020 ◽

Vol 65 (4) ◽

pp. 469-476

Author(s):

Jaroslav Prucha ◽

Vladimir Socha ◽

Lenka Hanakova ◽

Andrej Lalis ◽

Karel Hana

Keyword(s):

Lower Limb ◽

Compression Therapy ◽

Neurological Complications ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Therapeutic Procedures ◽

History Of ◽

Injury Recovery ◽

Type 2 Diabetic

AbstractThe present study aimed to evaluate the characteristic influence of physical therapeutic procedures of vacuum-compression therapy (VCT) on microvascular perfusion (MiP) and macrovascular perfusion (MaP) of the lower limb in diabetic patients. A sample of nine patients with a medical history of type 2 diabetes was used for the purpose of this study. Most of the subjects’ medical conditions included venous and neurological complications of the lower limb, whereas the rest of the subjects entered the treatment due to injury recovery or their phlebological disease. The PeriFlux System 5000 (Perimed, Sweden) diagnostic device was used to measure MiP. The MaP was evaluated based on the perfusion index (PI) using the Extremiter monitoring device (Embitron, Czech Republic) designed to perform VCT procedures. The study found that MiP and MaP increase as an effect of VCT procedures and at the same time PI clearly reflects the effect of the applied vacuum and compression phases, verifying the method’s vital influence on peripheral perfusion disorders.

Download Full-text

Relationship Between Carotid Intima-Media Thickness and the Presence and Extent of Coronary Stenosis in Type 2 Diabetic Patients With Carotid Atherosclerosis but Without History of Coronary Artery Disease

Diabetes Care ◽

10.2337/dc10-1222 ◽

2011 ◽

Vol 34 (2) ◽

pp. 468-470 ◽

Cited By ~ 20

Author(s):

R. Kasami ◽

H. Kaneto ◽

N. Katakami ◽

S. Sumitsuji ◽

K. Yamasaki ◽

...

Keyword(s):

Coronary Stenosis ◽

Carotid Atherosclerosis ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

History Of ◽

Artery Disease ◽

Type 2 Diabetic

Download Full-text

Maximum carotid intima-media thickness improves the prediction ability of coronary artery stenosis in type 2 diabetic patients without history of coronary artery disease

Atherosclerosis ◽

10.1016/j.atherosclerosis.2012.01.022 ◽

2012 ◽

Vol 221 (2) ◽

pp. 438-444 ◽

Cited By ~ 34

Author(s):

Yoko Irie ◽

Naoto Katakami ◽

Hideaki Kaneto ◽

Ryuichi Kasami ◽

Satoru Sumitsuji ◽

...

Keyword(s):

Coronary Artery ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Prediction Ability ◽

History Of ◽

Artery Disease ◽

Type 2 Diabetic

Download Full-text

Accelerated metabolic susceptibility to type 2 diabetes in older women with a history of gestational diabetes

Endocrine Connections ◽

10.1530/ec-12-0072 ◽

2013 ◽

Vol 2 (2) ◽

pp. 79-86 ◽

Cited By ~ 4

Author(s):

Alice S Ryan ◽

John C McLenithan ◽

Gretchen M Zietowski

Keyword(s):

Type 2 Diabetes ◽

Gestational Diabetes ◽

Postmenopausal Women ◽

Central Obesity ◽

Glucose Utilization ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Increased Risk ◽

History Of

The purpose of this study is to compare central obesity, insulin sensitivity, and cardiovascular disease risk factors between premenopausal and postmenopausal women with a history of gestational diabetes mellitus (GDM), controls, and women with type 2 diabetes (T2DM). Subjects were 73 overweight/obese and sedentary women who had a history of GDM (n=31) and were either premenopausal (n=11, 44±1 years, X±s.e.m.), postmenopausal (n=20, 58±1 years), or without a history of GDM as healthy postmenopausal controls (n=27, 57±1 years) or postmenopausal with T2DM (n=16, 59±1 years). The premenopausal GDM women had higher maximal oxygen uptake and lower visceral fat than the other three groups (P<0.05). BMI, %body fat, subcutaneous abdominal fat, and intramuscular fat did not differ significantly among the four groups. Glucose utilization (M, 3 h 40 mU/m2 per min hyperinsulinemic–euglycemic clamps) was 27% higher (P=0.05) in pre- than postmenopausal GDM and was not different between premenopausal GDM and postmenopausal controls. M was 28% lower (P=0.06) in postmenopausal GDM than controls and was not significantly different between postmenopausal GDM and T2DM groups. Thus, despite being younger and more physically fit, premenopausal women with prior GDM display similar central obesity, glucose, and metabolic profiles as postmenopausal controls. Postmenopausal women with prior GDM are more insulin resistant than controls of similar age, adiposity, and fitness levels and display comparable glucose utilization rates as similar as women with T2DM suggesting that a prior history of GDM may be an early manifestation of increased risk of later T2DM.

Download Full-text

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.

Download Full-text