Deficits in trabecular bone microarchitecture in young women with Type 1 diabetes mellitus

Abdalrahaman, N. et al. (2015) Deficits in trabecular bone microarchitecture in young women with Type 1 diabetes mellitus. Journal of Bone and Mineral Research, 30(8), pp. 1386-1393. (doi: 10.1002/jbmr.2465) (PMID:25627460)

Abstract

Context: The pathophysiological mechanism of increased fractures in young adults with Type 1 Diabetes Mellitus (T1DM) is unclear. Objective: Case:control study of trabecular bone microarchitecture and vertebral marrow adiposity in young women with T1DM. Patients and Settings: 30 women with T1DM with a median (range) age of 22.0yrs (16.9, 36.1) attending one outpatient clinic with a median age at diagnosis of 9.7yrs (0.46, 14.8) were compared to 28 age-matched healthy women who acted as controls. Methods and Main Outcome Measures: Measurements included MRI-based assessment of proximal tibial bone volume/total volume (appBV/TV), trabecular separation (appTb.Sp), vertebral bone marrow adiposity (BMA) and abdominal adipose tissue and biochemical markers of GH/IGF-1 axis (IGF-1, IGFBP3, ALS) and bone turnover. Results: Median appBV/TV in cases and controls was 0.3 (0.22, 0.37) and 0.33 (0.26, 0.4), respectively (p = 0.018) and median appTb.Sp in T1DM was 2.59 (2.24, 3.38) and 2.32 (2.03, 2.97), respectively (p = 0.012). The median appBV/TV was 0.28 (0.22, 0.33) in those cases with retinopathy (n,15) compared to 0.33 (0.25, 0.37) in those without retinopathy (p = 0.02). Although median visceral adipose tissue in cases was higher than in controls at 5,733mm3 (2030, 11,144) and 3,460mm3 (1,808, 6,832), respectively (p = 0.012), there was no difference in median BMA which was 31.1% (9.9, 59.9) and 26.3% (8.5, 49.8) in cases and controls, respectively (p = 0.2). Serum IGF-1 and ALS were also lower in cases and the latter showed an inverse association to appTbSp (r = -0.30, p = 0.04). Conclusion: Detailed MRI studies in young women with childhood-onset T1DM have shown clear deficits in trabecular microarchitecture of the tibia. Underlying pathophysiological mechanisms may include a microvasculopathy.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Lindsay, Dr Robert and ABDALRAHAMAN, Naiemh and Foster, Dr John and Mccomb, Dr Christie and Perry, Dr Colin and McLean, Dr Jennifer and McMillan, Mr Martin and Gordon, Dr Derek and Shaikh, Dr Mohammed Guftar and Ahmed, Professor Syed Faisal and Drummond, Dr Russell and McKay, Dr Gerard and McClure, Dr John
• Authors: Abdalrahaman, N., Mccomb, C., Foster, J. E., McLean, J., Lindsay, R. S., McClure, J., McMillan, M., Drummond, R., Gordon, D., McKay, G. A., Shaikh, M. G., Perry, C. G., and Ahmed, S. F.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Journal of Bone and Mineral Research
• Publisher: Wiley-Blackwell Publishing, Inc.
• ISSN: 0884-0431
• ISSN (Online): 1523-4681
• Published Online: 17 July 2015
• Copyright Holders: Copyright © 2015 Wiley-Blackwell Publishing, Inc.
• First Published: First published in Journal of Bone and Mineral Research 30(8):1386-1393
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher