Abstract：
This study aimed to evaluate bone mineral density (BMD), trabecular microarchitecture, and proximal hip geometry in diabetic postmenopausal women, where BMD alone cannot reflect bone strength adequately. We found significantly lower trabecular bone score and BMD at the distal radius and total forearm in diabetic subjects compared to controls.
The limitations resulting from the exclusive assessment of bone mineral density (BMD) in people with diabetes can lead to underestimation of microarchitectural and geometric changes, both of which play an essential role in the fracture risk. Therefore, we aimed to evaluate BMD, trabecular bone score (TBS), and hip structural analysis (HSA) in diabetic type-2 post-menopausal women and compare them with healthy postmenopausal subjects.
BMD was assessed at the lumbar spine, femoral sites, distal radius, and total forearm using dual-energy X-ray absorptiometry (DXA); TBS was measured based on DXA images using the software at the same region of interest as the BMD measurements; geometric assessment at the proximal femur was performed by the HSA program.
A total of 348 ambulatory type-2 diabetic postmenopausal women and 539 healthy postmenopausal women were enrolled. TBS and BMD at the distal radius and total forearm were significantly (P value < 0.05) lower in cases compared to controls after age and body mass index (BMI) adjustment. In addition, degraded bone microarchitecture was significantly (P value < 0.05) more prevalent in diabetic subjects than in non-diabetic controls after adjusting for age and BMI. A number of geometric indices of the proximal hip were significantly lower in the controls than in those with diabetes (P-value < 0.05).
This study may highlight the utility of the TBS and BMD at the distal radius and total forearm in subjects with type-2 diabetes mellitus, where the BMD at central sites may not adequately predict fracture risk.
The limitations resulting from the exclusive assessment of bone mineral density (BMD) in people with diabetes can lead to underestimation of microarchitectural and geometric changes, both of which play an essential role in the fracture risk. Therefore, we aimed to evaluate BMD, trabecular bone score (TBS), and hip structural analysis (HSA) in diabetic type-2 post-menopausal women and compare them with healthy postmenopausal subjects.
BMD was assessed at the lumbar spine, femoral sites, distal radius, and total forearm using dual-energy X-ray absorptiometry (DXA); TBS was measured based on DXA images using the software at the same region of interest as the BMD measurements; geometric assessment at the proximal femur was performed by the HSA program.
A total of 348 ambulatory type-2 diabetic postmenopausal women and 539 healthy postmenopausal women were enrolled. TBS and BMD at the distal radius and total forearm were significantly (P value < 0.05) lower in cases compared to controls after age and body mass index (BMI) adjustment. In addition, degraded bone microarchitecture was significantly (P value < 0.05) more prevalent in diabetic subjects than in non-diabetic controls after adjusting for age and BMI. A number of geometric indices of the proximal hip were significantly lower in the controls than in those with diabetes (P-value < 0.05).
This study may highlight the utility of the TBS and BMD at the distal radius and total forearm in subjects with type-2 diabetes mellitus, where the BMD at central sites may not adequately predict fracture risk.
摘要：
本研究旨在评估骨密度（BMD），小梁微结构，和绝经后糖尿病妇女的近端髋关节几何形状，仅BMD不能充分反映骨强度。我们发现，与对照组相比，糖尿病患者桡骨远端和前臂的骨小梁评分和BMD明显降低。
目的：对糖尿病患者的骨矿物质密度（BMD）进行独家评估所造成的局限性可能会导致对微观结构和几何变化的低估。两者在骨折风险中起着至关重要的作用。因此,我们的目标是评估骨密度，骨小梁评分(TBS),2型糖尿病绝经后妇女的髋关节结构分析（HSA），并将其与健康的绝经后受试者进行比较。
方法：评估腰椎的BMD，股骨部位,桡骨远端,使用双能X线骨密度仪（DXA）和总前臂；基于DXA图像，使用软件在与BMD测量相同的感兴趣区域测量TBS；通过HSA程序进行股骨近端几何评估。
结果：共纳入348名门诊2型糖尿病绝经后妇女和539名健康绝经后妇女。在年龄和体重指数（BMI）调整后，与对照组相比，桡骨远端和整个前臂的TBS和BMD显着降低（P值<0.05）。此外,校正年龄和BMI后,糖尿病患者的骨微结构退化显著(P值<0.05)高于非糖尿病对照组。与糖尿病患者相比，对照组的近端髋关节的许多几何指标显着降低（P值<0.05）。
结论：这项研究可能突出了TBS和BMD在2型糖尿病患者中桡骨远端和整个前臂的应用，中央部位的BMD可能无法充分预测骨折风险。
目的：对糖尿病患者的骨矿物质密度（BMD）进行独家评估所造成的局限性可能会导致对微观结构和几何变化的低估。两者在骨折风险中起着至关重要的作用。因此,我们的目标是评估骨密度，骨小梁评分(TBS),2型糖尿病绝经后妇女的髋关节结构分析（HSA），并将其与健康的绝经后受试者进行比较。
方法：评估腰椎的BMD，股骨部位,桡骨远端,使用双能X线骨密度仪（DXA）和总前臂；基于DXA图像，使用软件在与BMD测量相同的感兴趣区域测量TBS；通过HSA程序进行股骨近端几何评估。
结果：共纳入348名门诊2型糖尿病绝经后妇女和539名健康绝经后妇女。在年龄和体重指数（BMI）调整后，与对照组相比，桡骨远端和整个前臂的TBS和BMD显着降低（P值<0.05）。此外,校正年龄和BMI后,糖尿病患者的骨微结构退化显著(P值<0.05)高于非糖尿病对照组。与糖尿病患者相比，对照组的近端髋关节的许多几何指标显着降低（P值<0.05）。
结论：这项研究可能突出了TBS和BMD在2型糖尿病患者中桡骨远端和整个前臂的应用，中央部位的BMD可能无法充分预测骨折风险。
