Abstract：
BACKGROUND: Impaired bone microarchitecture, assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT), may contribute to bone fragility in type 2 diabetes (T2DM) but data on men are lacking.
OBJECTIVE: To investigate the association between T2DM and HR-pQCT parameters in older men.
METHODS: HR-pQCT scans were acquired on 1794 participants in the Osteoporotic Fractures in Men (MrOS) study. T2DM was ascertained by self-report or medication use. Linear regression models, adjusted for age, race, BMI, limb length, clinic site, and oral corticosteroid use, were used to compare HR-pQCT parameters by diabetes status.
RESULTS: Among 1777 men, 290 had T2DM (mean age 84.4 years). T2DM men had smaller total cross-sectional area (Tt.AR) at the distal tibia (p=0.028) and diaphyseal tibia (p=0.025), and smaller cortical area at the distal (p= 0.009) and diaphyseal tibia (p= 0.023). Trabecular indices and cortical porosity were similar between T2DM and non-T2DM. Among men with T2DM, in a model including HbA1c, diabetes duration, and insulin use, diabetes duration ≥ 10 years, compared with <10 years, was significantly associated with higher cortical porosity but with higher trabecular thickness at the distal radius. Insulin use was significantly associated with lower cortical area and thickness at the distal radius and diaphyseal tibia and lower failure load at all three scan sites. Lower cortical area, cortical thickness, total BMD, cortical BMD, and failure load of the distal sites were associated with increased risk of incident non-vertebral fracture in T2DM.
CONCLUSIONS: Older men with T2DM have smaller bone size compared to non-T2DM, which may contribute to diabetic skeletal fragility. Longer diabetes duration was associated with higher cortical porosity and insulin use with cortical bone deficits and lower failure load.
OBJECTIVE: To investigate the association between T2DM and HR-pQCT parameters in older men.
METHODS: HR-pQCT scans were acquired on 1794 participants in the Osteoporotic Fractures in Men (MrOS) study. T2DM was ascertained by self-report or medication use. Linear regression models, adjusted for age, race, BMI, limb length, clinic site, and oral corticosteroid use, were used to compare HR-pQCT parameters by diabetes status.
RESULTS: Among 1777 men, 290 had T2DM (mean age 84.4 years). T2DM men had smaller total cross-sectional area (Tt.AR) at the distal tibia (p=0.028) and diaphyseal tibia (p=0.025), and smaller cortical area at the distal (p= 0.009) and diaphyseal tibia (p= 0.023). Trabecular indices and cortical porosity were similar between T2DM and non-T2DM. Among men with T2DM, in a model including HbA1c, diabetes duration, and insulin use, diabetes duration ≥ 10 years, compared with <10 years, was significantly associated with higher cortical porosity but with higher trabecular thickness at the distal radius. Insulin use was significantly associated with lower cortical area and thickness at the distal radius and diaphyseal tibia and lower failure load at all three scan sites. Lower cortical area, cortical thickness, total BMD, cortical BMD, and failure load of the distal sites were associated with increased risk of incident non-vertebral fracture in T2DM.
CONCLUSIONS: Older men with T2DM have smaller bone size compared to non-T2DM, which may contribute to diabetic skeletal fragility. Longer diabetes duration was associated with higher cortical porosity and insulin use with cortical bone deficits and lower failure load.
摘要：
背景：骨微结构受损，通过高分辨率外周定量计算机断层扫描（HR-pQCT）评估，可能导致2型糖尿病（T2DM）患者的骨脆性，但缺乏男性数据。
目的：探讨老年男性T2DM与HR-pQCT参数的相关性。
方法：对男性骨质疏松性骨折（MrOS）研究的1794名参与者进行了HR-pQCT扫描。通过自我报告或药物使用确定T2DM。线性回归模型，根据年龄调整，种族,BMI,肢体长度,诊所现场,口服皮质类固醇，用于比较HR-pQCT参数与糖尿病状态。
结果：在1777名男性中，290人患有T2DM（平均年龄84.4岁）。T2DM男性总横截面面积较小（Tt。AR）在胫骨远端（p=0.028）和胫骨干（p=0.025），远端（p=0.009）和胫骨干（p=0.023）的皮质面积较小。T2DM和非T2DM的骨小梁指数和皮质孔隙度相似。在患有T2DM的男性中，在包含HbA1c的模型中，糖尿病持续时间，和胰岛素的使用，糖尿病病程≥10年，与<10年相比，与较高的皮质孔隙率显着相关，但与桡骨远端小梁厚度较高相关。胰岛素的使用与桡骨远端和胫骨干的皮质面积和厚度较低以及所有三个扫描部位的失效负荷较低显著相关。下皮质区，皮质厚度,总BMD,皮质骨密度,远端部位的失效负荷与T2DM非椎体骨折的风险增加相关.
结论：与非T2DM相比，老年T2DM患者的骨尺寸较小，这可能导致糖尿病骨骼脆弱。较长的糖尿病病程与较高的皮质孔隙率和胰岛素使用以及皮质骨缺损和较低的失败负荷相关。
目的：探讨老年男性T2DM与HR-pQCT参数的相关性。
方法：对男性骨质疏松性骨折（MrOS）研究的1794名参与者进行了HR-pQCT扫描。通过自我报告或药物使用确定T2DM。线性回归模型，根据年龄调整，种族,BMI,肢体长度,诊所现场,口服皮质类固醇，用于比较HR-pQCT参数与糖尿病状态。
结果：在1777名男性中，290人患有T2DM（平均年龄84.4岁）。T2DM男性总横截面面积较小（Tt。AR）在胫骨远端（p=0.028）和胫骨干（p=0.025），远端（p=0.009）和胫骨干（p=0.023）的皮质面积较小。T2DM和非T2DM的骨小梁指数和皮质孔隙度相似。在患有T2DM的男性中，在包含HbA1c的模型中，糖尿病持续时间，和胰岛素的使用，糖尿病病程≥10年，与<10年相比，与较高的皮质孔隙率显着相关，但与桡骨远端小梁厚度较高相关。胰岛素的使用与桡骨远端和胫骨干的皮质面积和厚度较低以及所有三个扫描部位的失效负荷较低显著相关。下皮质区，皮质厚度,总BMD,皮质骨密度,远端部位的失效负荷与T2DM非椎体骨折的风险增加相关.
结论：与非T2DM相比，老年T2DM患者的骨尺寸较小，这可能导致糖尿病骨骼脆弱。较长的糖尿病病程与较高的皮质孔隙率和胰岛素使用以及皮质骨缺损和较低的失败负荷相关。
