title: Bone structure and turnover in type 2 diabetes mellitus.
abstract: CONCLUSIONS
  We compared skeletal parameters in type 2 diabetic (T2DM) and non-diabetic postmenopausal women. Bone structure by dual energy x-ray absorptiometry (DXA) and HR-pQCT was not different, although procollagen type 1 amino-terminal propeptide (P1NP) and osteocalcin levels were lower in T2DM.
  
  
  BACKGROUND
  T2DM is associated with increased fracture risk, but, paradoxically, with higher cross-sectional bone density (BMD) as measured by DXA. We sought explanations to this puzzle by investigating detailed structural and biochemical skeletal parameters in T2DM.
  
  
  METHODS
  Cross-sectional comparison of 25 postmenopausal T2DM women and 25 matched controls using DXA, high-resolution peripheral quantitative computed tomography (HR-pQCT) and biochemical bone turnover markers.
  
  
  RESULTS
  BMD by DXA did not differ between T2DM and controls. HR-pQCT assessment also did not differ, with the exception of cortical area at the tibia, which tended to be lower in the diabetics (difference of 12 ± 6 [mean ± SD] mm, p = 0.06). P1NP and osteocalcin levels were lower in T2DM as compared to controls (P1NP, 34.3 ± 16 vs. 57.3 ± 28 ng/ml; p = 0.005; osteocalcin, 4.5 ± 2 vs. 6.2 ± 2 nmol/L; p = 0.001).
  
  
  CONCLUSIONS
  Postmenopausal women with T2DM had lower levels of bone formation markers as compared to controls. Aside from a possible decrease in cortical bone area at a weight-bearing site, bone structure was not altered in T2DM. Lower bone turnover may be a skeletal parameter that is present in T2DM.
authors.affiliation: Department of Medicine, Division of Endocrinology, Metabolic Bone Diseases Unit, College of Physicians and Surgeons, Columbia University, 630 W. 168th St, New York, NY 10032, USA.
authors.forename: A
authors.initials: A
authors.lastname: Shu
authors.forename: M T
authors.initials: MT
authors.lastname: Yin
authors.forename: E
authors.initials: E
authors.lastname: Stein
authors.forename: S
authors.initials: S
authors.lastname: Cremers
authors.forename: E
authors.initials: E
authors.lastname: Dworakowski
authors.forename: R
authors.initials: R
authors.lastname: Ives
authors.forename: M R
authors.initials: MR
authors.lastname: Rubin
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology*; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D017698:Postmenopause / Q000378:metabolism; D011347:Procollagen / Q000097:blood; D011884:Radius / Q000503:physiopathology; D013977:Tibia / Q000503:physiopathology; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D010446:Peptide Fragments; D011347:Procollagen; C047202:procollagen Type I N-terminal peptide; D015675:Osteocalcin