Volumetric femoral BMD, bone geometry, and serum sclerostin levels differ between type 2 diabetic postmenopausal women with and without fragility fractures
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- 作者：U. Heilmeier ; D. R. Carpenter ; J. M. Patsch ; R. Harnish…
- 关键词：Bone geometry ; Fracture risk ; Quantitative computed tomography ; Sclerostin ; Type 2 diabetes mellitus ; Volumetric bone mineral density
- 刊名：Osteoporosis International
- 出版年：2015
- 出版时间：April 2015
- 年：2015
- 卷：26
- 期：4
- 页码：1283-1293
- 全文大小：970 KB
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15. Sarahrudi, K, Thomas, A, Albrecht, C, Aharinejad, S (2012) Strongly enhanced levels of sclerostin during human fracture healing. J Orthop Res - 刊物类别：Medicine
- 刊物主题：Medicine & Public Health
Orthopedics
Gynecology
Endocrinology
Rheumatology - 出版者：Springer London
- ISSN：1433-2965
文摘
Summary While type 2 diabetes (T2D) is associated with higher skeletal fragility, specific risk stratification remains incompletely understood. We found volumetric bone mineral density, geometry, and serum sclerostin differences between low-fracture risk and high-fracture risk T2D women. These features might help identify T2D individuals at high fracture risk in the future. Introduction Diabetic bone disease, an increasingly recognized complication of type 2 diabetes mellitus (T2D), is associated with high skeletal fragility. Exactly which T2D individuals are at higher risk for fracture, however, remains incompletely understood. Here, we analyzed volumetric bone mineral density (vBMD), geometry, and serum sclerostin levels in two specific T2D subsets with different fracture risk profiles. We examined a T2D group with prior history of fragility fractures (DMFx, assigned high-risk group) and a fracture-free T2D group (DM, assigned low-risk group) and compared their results to nondiabetic controls with (Fx) and without fragility fractures (Co). Methods Eighty postmenopausal women (n--0 per group) underwent quantitative computed tomography (QCT) to compute vBMD and bone geometry of the proximal femur. Additionally, serum sclerostin, vitamin D, parathyroid hormone (PTH), HbA1c, and glomerular filtration rate (GFR) levels were measured. Statistical analyses employed linear regression models. Results DMFx subjects exhibited up to 33?% lower femoral neck vBMD than DM subjects across all femoral sites (?9?%?≤?ΔvBMD?≤??33?%, 0.008?≤-em class="a-plus-plus">p?≤0.021). Additionally, DMFx subjects showed significantly thinner cortices (??%, p--.046) and a trend toward larger bone volume (+10?%, p--.055) relative to DM women and higher serum sclerostin levels when compared to DM (+31.4?%, p--.013), Fx (+25.2?%, p--.033), and control (+22.4?%, p--.028) subjects. Conclusion Our data suggest that volumetric bone parameters by QCT and serum sclerostin levels can identify T2D individuals at high risk of fracture and might therefore show promise as clinical tools for fracture risk assessment in T2D. However, future research is needed to establish diabetes-specific QCT- and sclerostin-reference databases.