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


CONCLUSIONS
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.
McMaster University, Hamilton, Ontario, Canada.
Janet M
JM
Pritchard
Lora M
LM
Giangregorio
Stephanie A
SA
Atkinson
Karen A
KA
Beattie
Dean
D
Inglis
George
G
Ioannidis
Zubin
Z
Punthakee
J D
JD
Adachi
Alexandra
A
Papaioannou
D015502:Absorptiometry, Photon; D000368:Aged; D015519:Bone Density; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging / Q000473:pathology; D050723:Fractures, Bone / Q000209:etiology / Q000473:pathology; D006801:Humans; D016014:Linear Models; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D016017:Odds Ratio; D009864:Ontario; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D011884:Radius / Q000473:pathology*; D018570:Risk Assessment; D012307:Risk Factors