title: Deficits in Trabecular Bone Microarchitecture in Young Women With Type 1 Diabetes Mellitus.
abstract: The pathophysiological mechanism of increased fractures in young adults with type 1 diabetes mellitus (T1DM) is unclear. We conducted a case-control study of trabecular bone microarchitecture and vertebral marrow adiposity in young women with T1DM. Thirty women with T1DM with a median age (range) age of 22.0 years (16.9, 36.1) attending one outpatient clinic with a median age at diagnosis of 9.7 years (0.46, 14.8) were compared with 28 age-matched healthy women who acted as controls. Measurements included MRI-based assessment of proximal tibial bone volume/total volume (appBV/TV), trabecular separation (appTb.Sp), vertebral bone marrow adiposity (BMA), and abdominal adipose tissue and biochemical markers of GH/IGF-1 axis (IGF-1, IGFBP3, ALS) and bone turnover. Median appBV/TV in cases and controls was 0.3 (0.22, 0.37) and 0.33 (0.26, 0.4), respectively (p = 0.018) and median appTb.Sp in T1DM was 2.59 (2.24, 3.38) and 2.32 (2.03, 2.97), respectively (p = 0.012). The median appBV/TV was 0.28 (0.22, 0.33) in those cases with retinopathy (n = 15) compared with 0.33 (0.25, 0.37) in those without retinopathy (p = 0.02). Although median visceral adipose tissue in cases was higher than in controls at 5733 mm(3) (2030, 11,144) and 3460 mm(3) (1808, 6832), respectively (p = 0.012), there was no difference in median BMA, which was 31.1% (9.9, 59.9) and 26.3% (8.5, 49.8) in cases and controls, respectively (p = 0.2). Serum IGF-1 and ALS were also lower in cases, and the latter showed an inverse association to appTbSp (r = -0.30, p = 0.04). Detailed MRI studies in young women with childhood-onset T1DM have shown clear deficits in trabecular microarchitecture of the tibia. Underlying pathophysiological mechanisms may include a microvasculopathy.
authors: Developmental Endocrinology Research Group, School of Medicine, University of Glasgow, Glasgow, UK.
authors: Naiemh
authors: N
authors: Abdalrahaman
authors: Clinical Physics, NHS Greater Glasgow & Clyde, Glasgow, UK.|BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
authors: Christie
authors: C
authors: McComb
authors: Clinical Physics, NHS Greater Glasgow & Clyde, Glasgow, UK.|BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
authors: John E
authors: JE
authors: Foster
authors: Clinical Physics, NHS Greater Glasgow & Clyde, Glasgow, UK.|Institute of Neurological Sciences, Southern General Hospital, Glasgow, UK.
authors: John
authors: J
authors: McLean
authors: BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.|Stobhill Diabetes Centre, Stobhill Hospital, Glasgow, UK.
authors: Robert S
authors: RS
authors: Lindsay
authors: BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
authors: John
authors: J
authors: McClure
authors: Developmental Endocrinology Research Group, School of Medicine, University of Glasgow, Glasgow, UK.
authors: Martin
authors: M
authors: McMillan
authors: Stobhill Diabetes Centre, Stobhill Hospital, Glasgow, UK.
authors: Russell
authors: R
authors: Drummond
authors: Stobhill Diabetes Centre, Stobhill Hospital, Glasgow, UK.
authors: Derek
authors: D
authors: Gordon
authors: Stobhill Diabetes Centre, Stobhill Hospital, Glasgow, UK.
authors: Gerard A
authors: GA
authors: McKay
authors: Developmental Endocrinology Research Group, School of Medicine, University of Glasgow, Glasgow, UK.
authors: M Guftar
authors: MG
authors: Shaikh
authors: Stobhill Diabetes Centre, Stobhill Hospital, Glasgow, UK.
authors: Colin G
authors: CG
authors: Perry
authors: Developmental Endocrinology Research Group, School of Medicine, University of Glasgow, Glasgow, UK.
authors: S Faisal
authors: SF
authors: Ahmed
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000328:Adult; D048909:Diabetes Complications / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D005260:Female; D050723:Fractures, Bone / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D013131:Spine / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D013977:Tibia / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology
keywords: ADIPOSITY; BONE HEALTH; BONE MARROW; GLYCEMIA; MRI