title: Bone Microarchitecture in Type 1 Diabetes: It Is Complicated.
abstract: Patients with type 1 diabetes (T1DM) experience a disproportionate number of fractures for their bone mineral density (BMD). Differences in bone microarchitecture from those without the disease are thought to be responsible. However, the literature is inconclusive. New studies of the microarchitecture using three-dimensional imaging have the advantage of providing in vivo estimates of "bone quality," rather than examining areal BMD alone. There are drawbacks in that most studies have been done on those with less than a 30-year duration of T1DM, and the techniques used to measure vary as do the sites assessed. In addition to the rise in these imaging techniques, very recent literature presents evidence of an intimate relationship between skeletal health and vascular complications in T1DM. The following review provides an overview of the available studies of the bone microarchitecture in T1DM with a discussion of the burgeoning field of complications and skeletal health.
authors.affiliation: Research Division, Joslin Diabetes Center, Harvard Medical School, One Joslin Place, Boston, MA, 02215, USA. hillary.keenan@joslin.harvard.edu.
authors.forename: Hillary A
authors.initials: HA
authors.lastname: Keenan
authors.affiliation: Research Division, Joslin Diabetes Center, Harvard Medical School, One Joslin Place, Boston, MA, 02215, USA.|Department of Medicine, Unit of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Rome, Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Maddaloni
mesh_terms: D015502:Absorptiometry, Photon; D001847:Bone Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D000071556:Cancellous Bone / Q000000981:diagnostic imaging*; D000071538:Cortical Bone / Q000000981:diagnostic imaging*; D048909:Diabetes Complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D050723:Fractures, Bone / Q000453:epidemiology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed
keywords: Bone fragility; Bone quality; Complications; Diabetes; Microarchitecture; Type 1 diabetes