Men with type 1 diabetes are more likely to suffer bone fractures because of lower bone density, poorer bone quality and a lower rate of bone growth, according to a Norwegian study.
The study compared 31 male patients with type 1 diabetes and 28 healthy male age-matched controls – both groups having an average age of 41.
“Men with type 1 diabetes displayed lower bone density across the whole body”
The researchers found the diabetes group displayed lower whole body bone mineral density, compared to controls.
Osteopenia/osteoporosis were also more frequent in the type 1 group, although significantly only at the total hip. In addition, pine trabecular bone scores were lower in the diabetes group.
Meanwhile, lower levels of the bone resorption marker C-terminal telopeptide of type 1 collagen and the bone formation marker osteocalcin were observed in the type 1 diabetes group.
Study author Dr Astrid Kamilla Stunes, from the Norwegian University of Science and Technology in Trondheim, said: “Our aim was to investigate the quality and density of bones in men with type 1 diabetes mellitus.
“Our findings strongly support the conclusion that there is a direct association in men between type 1 diabetes mellitus and an increased likelihood of bone fractures, which might be explained by impaired bone quality and decreased bone density,” she said.
Explaining her findings, Dr Stunes stated: “Compared to the healthy men, we found – using X-ray and other tools – that men with type 1 diabetes displayed lower bone density across the whole body, together with more frequent bone disease, such as preosteoporosis and osteoporosis, at their hips.
Men with type 1 diabetes ‘more likely to suffer bone fractures’
“They also had a lower trabecular bone score – this is a measure of bone microarchitecture that, alongside bone density, is a good predictor of fracture risk,” she said. “And their bones had significantly lower mechanical strength.”
She added: “These findings were supported by blood samples, which also confirmed that there were no significant differences between those with diabetes and the healthy men in levels of calcium, parathyroid hormone or vitamin D3, which are often associated with bone disease.”
The study results were announced earlier this week at the annual European Calcified Tissue Society Congress in Salzburg, Austria.
About the study
The study, titled “Impaired bone quality, assessed by trabecular bone score and in vivo micro indentation, in men with type 1 diabetes mellitus”, was carried out by Unni Syversen, Ida Marie Mynarek, Trudes Seselie Jahr Iversen,Kristin Matre Aasarød, Mats Peder Mosti, Kristin Matre Aasarød, Bjørn Olav Åsvold and Astrid Kamilla Stunes of the Norwegian University of Science and Technology in Trondheim; Janne Reseland of the University of Oslo; Erik F. Eriksen of Oslo University Hospital; and Trude Basso of St. Olavs University Hospital, Trondheim.
Thirty-three men with T1DM (42.7±12.1 years) and 28 healthy male age-matched controls (41.8±12.0 years) were included in the study. BMD was measured by dual X-ray absorptiometry (DXA), applying Hologic Discovery, and spine trabecular bone score (TBS) was assessed by TBS iNsight software. Bone mechanical strength (BMS) was examined by micro indentation (Osteoprobe). Fasting blood samples were collected for analyses of glycated hemoglobin (HbA1c), bone markers, calcium, parathyroid hormone (PTH) and 25-hydroxy vitamin D3 (25OH(D)).
The T1DM group displayed lower whole body BMD compared to controls (-0.46 T-score, p=0.04). Osteopenia/osteoporosis were more frequent in the T1DM group, although significantly only at the total hip (p=0.03). TBS was lower in the T1DM group (-4.3%, p=0.016). BMS was measured in subgroups (T1DM: n=18, controls: n=14), and significantly lower BMS was observed in the T1DM group (-4.8%, p=0.004). HbA1c was 8.0±0.8% in the T1DM group, versus 5.3±0.3% in controls (p less than 0.001). Lower levels of the bone resorption marker C-terminal telopeptide of type 1 collagen (0.25 (0.22-0.39) µg/L versus 0.43 (0.33-0.56) µg/L, p=0.001), and the bone formation marker osteocalcin (0.60 (0.48-1.00) nmol/L versus 1.00 (0.78-1.3) nmol/L, p=0.012) were observed in the T1DM group. There were no significant differences in calcium, PTH or 25(OH)D levels.