Evaluation of Quality and Bone Microstructure Alterations in Patients with Type 2 Diabetes: A Narrative Review

Martínez‐Montoro, José Ignacio; García-Fontana, Beatriz; García-Fontana, Cristina; Muñóz-Torres, Manuel

doi:10.3390/jcm11082206

Cited by 10 publications

(12 citation statements)

References 132 publications

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“…To date, several imaging modalities, including DXA, radiography, micro-computed tomography, high-resolution peripheral quantitative computed tomography (HR-pQCT), and high-resolution magnetic resonance imaging, have been proposed for bone quality assessment[ 25 ]. Among these methods, HR-pQCT and TBS are the most used tools to study the bone microarchitecture in diabetes[ 26 ]. HR-pQCT is a non-invasive three-dimensional imaging modality for assessment of bone microarchitecture and bone strength in the appendicular skeleton ( i.e.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with trabecular bone score in postmenopausal women with type 2 diabetes and normal bone mineral density

Фазуллина

Korbut

Климонтов

2022

WJD

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BACKGROUND Osteoporosis and type 2 diabetes (T2D) have been recognized as a widespread comorbidity leading to excess mortality and an enormous healthcare burden. In T2D, bone mineral density (BMD) may underestimate the risk of low-energy fractures as bone quality is reduced. It was hypothesized that a decrease in the trabecular bone score (TBS), a parameter assessing bone microarchitecture, may be an early marker of impaired bone health in women with T2D. AIM To identify clinical and body composition parameters that affect TBS in postmenopausal women with T2D and normal BMD. METHODS A non-interventional cross-sectional comparative study was conducted. Potentially eligible subjects were screened at tertiary referral center. Postmenopausal women with T2D, aged 50-75 years, with no established risk factors for secondary osteoporosis, were included. BMD, TBS and body composition parameters were assessed by dual-energy X-ray absorptiometry. In women with normal BMD, a wide range of anthropometric, general and diabetes-related clinical and laboratory parameters were evaluated as risk factors for TBS decrease using univariate and multivariate regression analysis and analysis of receiver operating characteristic (ROC) curves. RESULTS Three hundred twelve women were initially screened, 176 of them met the inclusion criteria and underwent dual X-ray absorptiometry. Those with reduced BMD were subsequently excluded; 96 women with normal BMD were included in final analysis. Among them, 43 women (44.8%) showed decreased TBS values (≤ 1.31). Women with TBS ≤ 1.31 were taller and had a lower body mass index (BMI) when compared to those with normal TBS ( Р = 0.008 and P = 0.007 respectively). No significant differences in HbA1c, renal function, calcium, phosphorus, alkaline phosphatase, PTH and 25(ОН)D levels were found. In a model of multivariate linear regression analysis, TBS was positively associated with gynoid fat mass, whereas the height and androgen fat mass were associated negatively (all P < 0.001). In a multiple logistic regression, TBS ≤ 1.31 was associated with lower gynoid fat mass (adjusted odd ratio [OR], 0.9, 95% confidence interval [CI], 0.85-0.94, P < 0.001), higher android fat mass (adjusted OR, 1.13, 95%CI, 1.03-1.24, P = 0.008) and height (adjusted OR, 1.13, 95%CI, 1.05-1.20, P < 0.001). In ROC-curve analysis, height ≥ 162.5 cm ( P = 0.04), body mass index ≤ 33.85 kg/m 2 ( P = 0.002), gynoid fat mass ≤ 5.41 kg ( P = 0.03) and android/gynoid fat mass ratio ≥ 1.145 ( P < 0.001) were identified as the risk factors for TBS reduction. CONCLUSION In postmenopausal women with T2D and normal B...

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Section: Discussionmentioning

confidence: 99%

Factors associated with trabecular bone score in postmenopausal women with type 2 diabetes and normal bone mineral density

Фазуллина

Korbut

Климонтов

2022

WJD

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“…So poor bone quality, such as deteriorated bone microarchitecture, has been suggested to contribute to skeletal fragility in T2D. Three major techniques [the trabecular bone score (TBS), high-resolution peripheral quantitative computed tomography (HRpQCT), and microindentation] have been used to evaluate bone microstructure in T2D [21]. TBS is derived from the two-dimensional lumbar spine DXA image, with a lower score indicating a reduced number of trabeculae and less connectivity.…”

Section: Skeletal Health In Diabetesmentioning

confidence: 99%

“…TBS is derived from the two-dimensional lumbar spine DXA image, with a lower score indicating a reduced number of trabeculae and less connectivity. There is evidence to support that persons with T2D have a significantly lower TBS value despite higher BMD levels, suggesting TBS may be a useful approach for the diagnosis of bone fragility and evaluation of fracture risk in T2D [21]. However, the findings using the HR-pQCT are conflicting.…”

Section: Skeletal Health In Diabetesmentioning

confidence: 99%

Weight Loss Interventions and Skeletal Health in Persons with Diabetes

Zhao

Khedkar

Johnson

2022

Curr Osteoporos Rep

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Purpose of Review Weight loss is recommended for improving glycemic control and reducing cardiovascular risk factors in persons with diabetes. However, both diabetes and weight loss have been associated with detrimental skeletal health. This review aims to summarize recent study findings on the effects of lifestyle interventions for weight loss on skeletal health among persons with type 2 diabetes (T2D). Recent Findings A few large-scale observational studies have demonstrated an increased fragility fracture risk associated with weight loss among persons with T2D. Randomized control trials in persons with T2D also have shown that intentional lifestyle interventions for weight loss are associated with a greater decrease in bone mineral density (BMD) and an increase in the risk of fracture. The biological mechanisms underlying the compromised bone health during lifestyle interventions for weight loss are complex and not yet conclusive. However, there is evidence to suggest that bone loss and increased fracture risk during intentional weight loss may be mitigated by some intervention approaches, such as high protein intake, calcium supplementation, and resistance and balance training. Summary There is still a lack of studies investigating the effects of different interventions for weight loss on skeletal health among persons with T2D. However, certain types of diet and physical activity intervention combined with bone monitoring and fracture risk prediction may help achieve weight loss goals and maintain skeletal health among persons with T2D during intentional weight loss.

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“…When compared to controls, T1DM patients’ bone stiffness and strength both significantly decreased ( 33 ). The microstructure of the bone in patients with T2DM is abnormal, mainly in the cancellous bone, with a decrease in the number of trabeculae and morphological disorders ( 32 , 34 , 35 ). The number of trabeculae and trabecular thickness of the femoral head is significantly lower in patients with T2DM than those in non-diabetic patients ( 36 , 37 ).…”

Section: Characteristics Of Diabetic Bone Diseasementioning

confidence: 99%

A narrative review of diabetic bone disease: Characteristics, pathogenesis, and treatment

Wang

et al. 2022

Front. Endocrinol.

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Recently, the increasing prevalence of diabetes mellitus has made it a major chronic illness which poses a substantial threat to human health. The prevalence of osteoporosis among patients with diabetes mellitus has grown considerably. Diabetic bone disease is a secondary osteoporosis induced by diabetes mellitus. Patients with diabetic bone disease exhibit variable degrees of bone loss, low bone mineral density, bone microarchitecture degradation, and increased bone fragility with continued diabetes mellitus, increasing their risk of fracture and impairing their ability to heal after fractures. At present, there is extensive research interest in diabetic bone disease and many significant outcomes have been reported. However, there are no comprehensive review is reported. This review elaborates on diabetic bone disease in the aspects of characteristics, pathogenesis, and treatment.

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Evaluation of Quality and Bone Microstructure Alterations in Patients with Type 2 Diabetes: A Narrative Review

Cited by 10 publications

References 132 publications

Factors associated with trabecular bone score in postmenopausal women with type 2 diabetes and normal bone mineral density

Factors associated with trabecular bone score in postmenopausal women with type 2 diabetes and normal bone mineral density

Weight Loss Interventions and Skeletal Health in Persons with Diabetes

A narrative review of diabetic bone disease: Characteristics, pathogenesis, and treatment

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