Association of larger holes in the trabecular bone at the distal radius in postmenopausal women with type 2 diabetes mellitus compared to controls
Article first published online: 28 DEC 2011
Copyright © 2012 by the American College of Rheumatology
Arthritis Care & Research
Volume 64, Issue 1, pages 83–91, January 2012
How to Cite
Pritchard, J. M., Giangregorio, L. M., Atkinson, S. A., Beattie, K. A., Inglis, D., Ioannidis, G., Punthakee, Z., Adachi, J. D. and Papaioannou, A. (2012), Association of larger holes in the trabecular bone at the distal radius in postmenopausal women with type 2 diabetes mellitus compared to controls. Arthritis Care Res, 64: 83–91. doi: 10.1002/acr.20602
- Issue published online: 28 DEC 2011
- Article first published online: 28 DEC 2011
- Accepted manuscript online: 30 AUG 2011 10:13AM EST
- Manuscript Accepted: 9 AUG 2011
- Manuscript Received: 1 APR 2011
- Lloyd Carr Harris Foundation
Vol. 64, Issue 6, 944, Article first published online: 25 MAY 2012
Adults with type 2 diabetes mellitus (DM) have an elevated fracture risk despite normal areal bone mineral density (aBMD). The study objective was to compare trabecular bone microarchitecture of postmenopausal women with type 2 DM and women without type 2 DM.
An extremity 1T magnetic resonance imaging system was used to acquire axial images (195 × 195 × 1,000 μm3 voxel size) of the distal radius of women recruited from outpatient clinics or by community advertisement. Image segmentation yielded geometric, topologic, and stereologic outcomes, i.e., number and size of trabecular bone network holes (marrow spaces), endosteal area, trabecular bone volume fraction, nodal and branch density, and apparent trabecular thickness, separation, and number. Lumbar spine (LS) and proximal femur BMD were measured with dual x-ray absorptiometry. Microarchitectural differences were assessed using linear regression and adjusted for percent body fat, ethnicity, timed up-and-go test, Charlson Index, and calcium and vitamin D intake; aBMD differences were adjusted for body mass index (BMI).
Women with type 2 DM (n = 30, mean ± SD age 71.0 ± 4.8 years) had larger holes (+13.3%; P = 0.001) within the trabecular bone network than women without type 2 DM (n = 30, mean ± SD age 70.7 ± 4.9 years). LS aBMD was greater in women with type 2 DM; however, after adjustment for BMI, LS aBMD did not differ between groups.
In women with type 2 DM, the average hole size within the trabecular bone network at the distal radius is greater compared to controls. This may explain the elevated fracture risk in this population.