title: Compromised cortical bone compartment in type 2 diabetes mellitus patients with microvascular disease.
abstract: OBJECTIVE
  Patients with type 2 diabetes mellitus (T2D) have an increased fracture risk despite a normal or elevated bone mineral density (BMD). The aim of this cross-sectional in vivo study was to assess parameters of peripheral bone microarchitecture, estimated bone strength and bone remodeling in T2D patients with and without diabetic microvascular disease (MVD+ and MVD- respectively) and to compare them with healthy controls.
  
  
  METHODS
  Fifty-one T2D patients (MVD+ group: n=25) were recruited from Funen Diabetic Database and matched for age, sex and height with 51 healthy subjects. High-resolution peripheral quantitative tomography (HR-pQCT) was used to assess bone structure at the non-dominant distal radius and tibia. Estimated bone strength was calculated using finite element analysis. Biochemical markers of bone turnover were measured in all participants.
  
  
  RESULTS
  After adjusting for BMI, MVD+ patients displayed lower cortical volumetric BMD (P=0.02) and cortical thickness (P=0.02) and higher cortical porosity at the radius (P=0.02) and a trend towards higher cortical porosity at the tibia (P=0.07) compared to controls. HR-pQCT parameters did not differ between MVD- and control subjects. Biochemical markers of bone turnover were significantly lower in MVD+ and MVD- patients compared to controls (all P<0.01). These were no significant correlations between disease duration, glycemic control (average glycated hemoglobin over the previous 3 years) and HR-pQCT parameters.
  
  
  CONCLUSIONS
  Cortical bone deficits are not a characteristic of all T2D patients but of a subgroup characterized by the presence of microvascular complications. Whether this influences fracture rates in these patients needs further investigation.
authors.affiliation: Department of EndocrinologyOdense University Hospital, Institute of Clinical Research, University of Southern Denmark, Kloevervaenget 6.1.sal, DK-5000 Odense C, DenmarkDepartments of Diagnostics and Medicine MResearch Center for Ageing and Osteoporosis, Glostrup Hospital, Copenhagen, Denmark vshanbhogue@health.sdu.dk.
authors.forename: Vikram V
authors.initials: VV
authors.lastname: Shanbhogue
authors.affiliation: Department of EndocrinologyOdense University Hospital, Institute of Clinical Research, University of Southern Denmark, Kloevervaenget 6.1.sal, DK-5000 Odense C, DenmarkDepartments of Diagnostics and Medicine MResearch Center for Ageing and Osteoporosis, Glostrup Hospital, Copenhagen, Denmark.
authors.forename: Stinus
authors.initials: S
authors.lastname: Hansen
authors.affiliation: Department of EndocrinologyOdense University Hospital, Institute of Clinical Research, University of Southern Denmark, Kloevervaenget 6.1.sal, DK-5000 Odense C, DenmarkDepartments of Diagnostics and Medicine MResearch Center for Ageing and Osteoporosis, Glostrup Hospital, Copenhagen, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Frost
authors.affiliation: Department of EndocrinologyOdense University Hospital, Institute of Clinical Research, University of Southern Denmark, Kloevervaenget 6.1.sal, DK-5000 Odense C, DenmarkDepartments of Diagnostics and Medicine MResearch Center for Ageing and Osteoporosis, Glostrup Hospital, Copenhagen, Denmark.
authors.forename: Niklas Rye
authors.initials: NR
authors.lastname: Jørgensen
authors.affiliation: Department of EndocrinologyOdense University Hospital, Institute of Clinical Research, University of Southern Denmark, Kloevervaenget 6.1.sal, DK-5000 Odense C, DenmarkDepartments of Diagnostics and Medicine MResearch Center for Ageing and Osteoporosis, Glostrup Hospital, Copenhagen, Denmark.
authors.forename: Anne Pernille
authors.initials: AP
authors.lastname: Hermann
authors.affiliation: Department of EndocrinologyOdense University Hospital, Institute of Clinical Research, University of Southern Denmark, Kloevervaenget 6.1.sal, DK-5000 Odense C, DenmarkDepartments of Diagnostics and Medicine MResearch Center for Ageing and Osteoporosis, Glostrup Hospital, Copenhagen, Denmark.
authors.forename: Jan Erik
authors.initials: JE
authors.lastname: Henriksen
authors.affiliation: Department of EndocrinologyOdense University Hospital, Institute of Clinical Research, University of Southern Denmark, Kloevervaenget 6.1.sal, DK-5000 Odense C, DenmarkDepartments of Diagnostics and Medicine MResearch Center for Ageing and Osteoporosis, Glostrup Hospital, Copenhagen, Denmark.
authors.forename: Kim
authors.initials: K
authors.lastname: Brixen
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001696:Biomechanical Phenomena; D015519:Bone Density / Q000502:physiology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000000981:diagnostic imaging*; D003925:Diabetic Angiopathies / Q000097:blood / Q000000981:diagnostic imaging*; D005260:Female; D020342:Finite Element Analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011884:Radius / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013977:Tibia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D015415:Biomarkers