Trabecular Bone Score Is a Valuable Addition to Bone Mineral Density for Bone Quality Assessment in Older Mexican American Women With Type 2 Diabetes

Rianon, Nahid J; Ambrose, Catherine G.; Buni, Maryam; Watt, Gordon P.; Ortíz, Carlos; Lee, Miryoung; McCormick, Joseph B.; Fisher‐Hoch, Susan P.

doi:10.1016/j.jocd.2018.02.004

Cited by 21 publications

(18 citation statements)

References 15 publications

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“…Notwithstanding, part of the divergence between results on the effects of type 2 diabetes on BMD may be as a consequence of heterogeneous study groups available in literature [9,15,28,29]. In this study, diabetic and non-diabetic groups were matched according to age, sex and body mass index (BMI).…”

Section: Discussionmentioning

confidence: 99%

Bone mineral density and mandibular osteoporotic alterations in type 2 diabetes

Munhoz

Choi

Abdala

et al. 2018

BDS

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Objective: To assess the influence of type 2 diabetes on bone mineral density in a group of type 2 diabetic patients, in comparison with non-diabetic patients. Additionally, to evaluate the correlation between mandibular cortical index and bone mineral density. Material and Methods: 48 patients (24 diabetics and 24 non-diabetics) referred for femur and spine densitometry and panoramic radiograph examination were included in this study. Patients were diagnosed based on densitometric results of the total femur and total spine. All panoramic radiomorphometric measurements were performed by 3 observers. Differences in T and Z-scores between both groups were evaluated with Mann-Whitney test and non-parametric correlations between mandibular cortical index and T/Z-scores were carried out with Spearman’s test. Results: Median T and Z-scores for total femur and total spine presented no statistical significant difference between diabetic and non-diabetic patients. In addition, only diabetics total femur and non-diabetics total spine T-scores were significantly correlated with mandibular cortical index. Conclusion: The present results suggest that type 2 diabetic patients have similar Z and T-scores in femur and spine when compared to non-diabetic patients. Mandibular cortical index, assessed on panoramic radiographs is inversely correlated with femur densitometry results in diabetics and spine bone mineral density in non-diabetic patients. KeywordsBone Mineral Density; Dual X-Ray Absorptiometry; Panoramic radiography; Osteoporosis; Type 2 Diabetes.

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Section: Discussionmentioning

confidence: 99%

Bone mineral density and mandibular osteoporotic alterations in type 2 diabetes

Munhoz

Choi

Abdala

et al. 2018

BDS

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“…The primary endpoint is baseline to end-of-study change in TBS, based on previous reports showing that it is consistently lower in T2D versus non-diabetic individuals 15–20…”

Section: Methods and Analysismentioning

confidence: 99%

“…Potential pitfalls include the lack of data on TBS change over time in T2D individuals and the impact of exercise on this surrogate measure of bone quality. However, an age-dependent reduction in TBS of up to 0.5%/year has been reported in the general population60–63 and such decrease is likely to be accelerated in patients with T2D, given the large reduction in TBS detected in T2D versus non-diabetic individuals 15–20 64. In addition, in osteoporotic individuals, TBS was shown to be markedly increased (by ~4% in 2–3 years) by osteoanabolic agents such as teriparatide, though less than spine BMD,65–67 whereas antiresorptive agents, which merely increase bone mineralisation, were virtually ineffective 63.…”

Section: Ethics and Disseminationmentioning

confidence: 99%

“…The trabecular bone score (TBS) is a grey-level texture measurement based on two-dimensional projection images acquired during a DXA lumbar spine scan 13. It was consistently found to be reduced in T2D patients with fracture versus those without14 and in T2D versus non-diabetic individuals15–20 and to predict fracture risk independently of BMD 15. Quantitative ultrasound (QUS) provides an estimate of BMD,21 which predicted fracture risk better than DXA-derived BMD in older women with T2D22; in addition, QUS evaluates microarchitecture and material properties 23 24.…”

Section: Introductionmentioning

confidence: 99%

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Study to Weigh the Effect of Exercise Training on BONE quality and strength (SWEET BONE) in type 2 diabetes: study protocol for a randomised clinical trial

et al. 2019

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IntroductionType 2 diabetes (T2D) is associated with an increased fracture risk despite normal-to-increased bone mineral density, suggesting reduced bone quality. Exercise may be effective in reducing fracture risk by ameliorating muscle dysfunction and reducing risk of fall, though it is unclear whether it can improve bone quality.Methods and analysisThe ‘Study to Weigh the Effect of Exercise Training on BONE quality and strength (SWEET BONE) in T2D’ is an open-label, assessor-blinded, randomised clinical trial comparing an exercise training programme of 2-year duration, specifically designed for improving bone quality and strength, with standard care in T2D individuals. Two hundred T2D patients aged 65–75 years will be randomised 1:1 to supervised exercise training or standard care, stratified by gender, age ≤ or >70 years and non-insulin or insulin treatment. The intervention consists of two weekly supervised sessions, each starting with 5 min of warm-up, followed by 20 min of aerobic training, 30 min of resistance training and 20 min of core stability, balance and flexibility training. Participants will wear weighted vests during aerobic and resistance training. The primary endpoint is baseline to end-of-study change in trabecular bone score, a parameter of bone quality consistently shown to be reduced in T2D. Secondary endpoints include changes in other potential measures of bone quality, as assessed by quantitative ultrasound and peripheral quantitative CT; bone mass; markers of bone turnover; muscle strength, mass and power; balance and gait. Falls and asymptomatic and symptomatic fractures will be evaluated over 7 years, including a 5-year post-trial follow-up. The superiority of the intervention will be assessed by comparing between-groups baseline to end-of-study changes.Ethics and disseminationThis study was approved by the institutional ethics committee. Written informed consent will be obtained from all participants. The study results will be submitted for peer-reviewed publication.Trial registration numberNCT02421393.

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“…[49][50] However, studies in di erent ethnic groups have shown variable results, particularly with respect to each gender. [51][52] Recent analyses indicate that TBS evaluated on DXA scans is inversely related to BMI and abdominal fat 53 , whether TBS represents alterations of bone structure in diabetes, therefore, remains unknown.…”

Section: Dual-energy X-ray Absorptiometry (Dxa) Scans Limitations Andmentioning

confidence: 99%

Management of Bone Fragility in a Patient with Type 2 Diabetes Mellitus

Gani¹

2019

SFP

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Patients with type 2 diabetes mellitus (DM2) are recognised to have a higher risk of fragility fractures. With the increasing prevalence of DM2 in Singapore and an ageing population, the impact of DM2 on fragility fracture is expected to rise. The aim of this article is to review updated information on bone fragility and fracture risk in DM2 patients, to discuss the impact of diabetes treatment on bone metabolism, as well as the efficacy of anti-osteoporosis treatments for this population. An algorithm is proposed for the identification and management of DM2 patients at increased fracture risk.

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Trabecular Bone Score Is a Valuable Addition to Bone Mineral Density for Bone Quality Assessment in Older Mexican American Women With Type 2 Diabetes

Cited by 21 publications

References 15 publications

Bone mineral density and mandibular osteoporotic alterations in type 2 diabetes

Bone mineral density and mandibular osteoporotic alterations in type 2 diabetes

Study to Weigh the Effect of Exercise Training on BONE quality and strength (SWEET BONE) in type 2 diabetes: study protocol for a randomised clinical trial

Management of Bone Fragility in a Patient with Type 2 Diabetes Mellitus

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