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. 2012 Jan;64(1):83-91.
doi: 10.1002/acr.20602.

Association of larger holes in the trabecular bone at the distal radius in postmenopausal women with type 2 diabetes mellitus compared to controls

Janet M Pritchard  1 , Lora M Giangregorio, Stephanie A Atkinson, Karen A Beattie, Dean Inglis, George Ioannidis, Zubin Punthakee, J D Adachi, Alexandra Papaioannou
Affiliations

Association of larger holes in the trabecular bone at the distal radius in postmenopausal women with type 2 diabetes mellitus compared to controls

Janet M Pritchard et al. Arthritis Care Res (Hoboken). 2012 Jan.

Erratum in

  • Arthritis Care Res (Hoboken). 2012 Jun;64(6):944

Abstract

Objective: 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.

Methods: An extremity 1T magnetic resonance imaging system was used to acquire axial images (195 × 195 × 1,000 μm(3) 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).

Results: 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.

Conclusion: 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.

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Figures

Figure 1
Figure 1
Path outlining participant recruitment and enrollment in the study. DM = diabetes mellitus; MRI = magnetic resonance imaging.
Figure 2
Figure 2
Representative coronal image of the nondominant distal radius (A) showing the placement of the reference line and the region of interest captured in the axial images (B and C [inverted image]). The most proximal edge of the radius at the articular surface was used as a landmark for all participants to set the horizontal reference line. Semiautomatic segmentation delineates the trabecular bone compartment (D) and thresholding separates the marrow and bone (E).
See this image and copyright information in PMC

References

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