Trabecular bone score in type 1 diabetes—a cross-sectional study

Neumann, Thomas; Lodes, S.; Kästner, B.; Lehmann, Thomas; Hans, Didier; Lamy, Olivier; Müller, Ulrich A.; Wolf, Günter; Sämann, A.

doi:10.1007/s00198-015-3222-y

Cited by 63 publications

(28 citation statements)

References 24 publications

(31 reference statements)

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“…In this study, no significant difference was noted in TBS values between diabetics and non-diabetics. However, TBS and HbA1c values were independently associated with fracture risk, with TBS values lower than 1.42 predictive for fracture [24]. Nevertheless, the Manitoba cohort study on 29,407 postmenopausal women over 50 in Canada and the Ansung cohort on 1229 men and 1529 postmenopausal women over 50 in Korea, lumbar TBS was lower in diabetic patients.…”

Section: Discussionmentioning

confidence: 89%

Effect of diabetes on BMD and TBS values as determinants of bone health in the elderly: Bushehr Elderly Health program

Ebrahimpur

Sharifi

Nezhad

et al. 2019

J Diabetes Metab Disord

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Background Considering the aging population associated with higher osteoporotic fracture risk, high prevalence of diabetes and its effect on bone health along with lack of information on bone quality using common methods (BMD) the aim of present study was to determine the association between trabecular bone score (TBS) and diabetes in an elderly population participating in Bushehr Elderly Health (BEH) program. Materials and methods This cross-sectional study was performed on data collected during the BEH Program, stage II. Anthropometric indices were measured based on NHANES III protocol. Diabetes and pre-diabetes were defined according to ADA Guideline 2018. Bone density was measured using DXA method (DXA, Discovery WI, Hologic Inc., USA). A software installed on the same device (TBS iNsight® software) was applied to assess TBS values. Variables related to bone health were compared based on their glycemic status (participants with diabetes, participants with prediabetes, and normoglycemic) using analysis of variance. Univariate and multivariate linear and logistic regression models were used to determine the association between TBS values and bone density in different glycemic states. Results The data of 2263 participant aged 60 years and over were analyzed. Mean TBS values were significantly different between participants with diabetes, participants with prediabetes, and normoglycemic groups (P = 0.004;, however, P trend was not significant (0.400)). Mean BMD values at femoral neck and lumbar spine were significantly higher in diabetics compared with those diagnosed with pre-diabetes; the latter also had higher bone density compared with normoglycemic individuals (both P ANOVA test and P trends for means were < 0.01]. In univariate linear regression model, TBS values were negatively associated with pre-diabetes (β = −0.070; P < 0.001) but not with diabetes (β = −0.002, P = 0.915). This significant relationship disappeared when the results were adjusted for BMI. In fully adjusted multivariate logistic regression models, odds ratio linking pre-diabetes and diabetes with spinal osteoporosis was 0.861 (CI 95% 0.670-1.105) and 0.525 (CI 95% 0.392-0.701), respectively. As for femoral osteoporosis, odds ratio was 0.615 (CI 95% 0.407-0.928) and 0.968 (CI 95% 0.629-1.489), correspondingly. Moreover, for cumulative osteoporosis, the odds were 0.843 (CI 95% 0.676-1.106) and 0.551 (CI 95% 0.415-0.732), respectively.

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Section: Discussionmentioning

confidence: 89%

Effect of diabetes on BMD and TBS values as determinants of bone health in the elderly: Bushehr Elderly Health program

Ebrahimpur

Sharifi

Nezhad

et al. 2019

J Diabetes Metab Disord

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“…Trabecular bone score (TBS) is a new texture parameter derived from DXA image of the spine and provides information related to bone microarchitecture and fracture risk. TBS was shown not to be significantly different between T1DM and healthy persons but to be lower in T1DM patients with prevalent fractures (117). A low TBS value increases the predicted fracture probability in T1DM to the same degree as in non-diabetic subjects ( Table 2).…”

Section: Evaluation and Management Of Bone Fragility In T1dmmentioning

confidence: 90%

MECHANISMS IN ENDOCRINOLOGY: Mechanisms and evaluation of bone fragility in type 1 diabetes mellitus

Hough

Pierroz²,

Cooper

et al. 2016

European Journal of Endocrinology

124

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Subjects with type 1 diabetes mellitus (T1DM) have decreased bone mineral density and an up to sixfold increase in fracture risk. Yet bone fragility is not commonly regarded as another unique complication of diabetes. Both animals with experimentally induced insulin deficiency syndromes and patients with T1DM have impaired osteoblastic bone formation, with or without increased bone resorption. Insulin/IGF1 deficiency appears to be a major pathogenetic mechanism involved, along with glucose toxicity, marrow adiposity, inflammation, adipokine and other metabolic alterations that may all play a role on altering bone turnover. In turn, increasing physical activity in children with diabetes as well as good glycaemic control appears to provide some improvement of bone parameters, although robust clinical studies are still lacking. In this context, the role of osteoporosis drugs remains unknown.

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“…In diseases with low leptinemia (anorexia nervosa and congenital generalized lipodystrophy without insulin resistance) and normal insulin, the BMD is low [39, 40]. If insulin is low and leptin is normal (T1D), there is a tendency to BMD and TBS to be normal or low [41]. Hyperinsulinemia is important to increase BMD.…”

Section: Discussionmentioning

confidence: 99%

Normal bone density and trabecular bone score, but high serum sclerostin in congenital generalized lipodystrophy

Lima

Nóbrega

Lima

et al. 2017

Bone

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Context Berardinelli-Seip Congenital Lipodystrophy (BSCL) is a rare autosomal recessive syndrome characterized by a difficulty in storing lipids in adipocytes, low body fat mass, hypoleptinemia, and hyperinsulinemia. Sclerostin is a product of SOST gene that blocks the Wnt/β-catenin pathway, decreasing bone formation and enhancing adipogenesis. There are no data about sclerostin in people with BSCL. Objective We aimed to evaluate serum sclerostin, bone mineral density (BMD), and L1-L4 Trabecular Bone Score (TBS) in BSCL patients, generating new knowledge about potential mechanisms involved in the bone alterations of these patients. Design, Setting, and Patients In this cross-sectional study, we included 11 diabetic patients with BSCL (age 24.7±8.1 years; 6 females). Sclerostin, leptin, L1-L4 TBS, BMD were measured. Potential pathophysiological mechanisms have been suggested. Results Mean serum sclerostin was elevated (44.7±13.4 pmol/L) and was higher in men than women (55.3±9.0 vs. 35.1±8.4 pmol/L, p=0.004). Median of serum leptin was low [0.9 ng/mL (0.5-1.9) ]. Seven out of 11 patients had normal BMD, while four patients had high bone mass (defined as Z-score>+2.5SD). Patients on insulin had lower sclerostin (37.3±9.2 vs. 52.6±13.4 pmol/L, p=0.05). The mean TBS was 1.402±0.106, and it was higher than 1.300 in nine patients. Conclusions Patients with lipoatrophic diabetes (BSCL) have high serum concentrations of sclerostin, normal or high BMD, and reasonable trabecular bone mass measured by TBS. This is the first report of high sclerostin and good bone microarchitecture (TBS) in BSCL patients.

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Trabecular bone score in type 1 diabetes—a cross-sectional study

Abstract: TBS values are lower in T1D patients with prevalent fractures, suggesting an alteration of bone strength in this subgroup of patients. Reliable TBS cutoffs for the prediction of fracture risk in T1D need to be determined in larger prospective studies.

Cited by 63 publications

References 24 publications

Effect of diabetes on BMD and TBS values as determinants of bone health in the elderly: Bushehr Elderly Health program

Effect of diabetes on BMD and TBS values as determinants of bone health in the elderly: Bushehr Elderly Health program

MECHANISMS IN ENDOCRINOLOGY: Mechanisms and evaluation of bone fragility in type 1 diabetes mellitus

Normal bone density and trabecular bone score, but high serum sclerostin in congenital generalized lipodystrophy

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