Bone mineral density in patients with longstanding type 1 diabetes: Results from the Canadian Study of Longevity in Type 1 Diabetes |
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| Authors: | Omar N. Alhuzaim Evan J.H. Lewis Leif E. Lovblom Marina Cardinez Daniel Scarr Genevieve Boulet Alanna Weisman Julie A. Lovshin Yuliya Lytvyn Hillary A. Keenan Michael H. Brent Narinder Paul Vera Bril David Z.I. Cherney Bruce A. Perkins |
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| Affiliation: | 1. Obesity, Endocrine and Metabolism Center, King Fahad Medical City, Riyadh, Saudi Arabia;2. Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Toronto, Ontario, Canada;3. Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada;4. Division of Nephrology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada;5. Research Division, Joslin Diabetes Center, Boston, MA, USA;6. Department of Ophthalmology and Vision Sciences, Department of Medicine, University of Toronto, Toronto, Ontario, Canada;7. Joint Department of Medical Imaging, Division of Cardiothoracic Radiology, University Health Network, Toronto, Ontario, Canada;8. The Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Krembil Neuroscience Centre, Division of Neurology, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada |
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| Abstract: | AimIt is currently unclear if longstanding type 1 diabetes (T1D) affects bone mineral density (BMD).MethodsBMD measured by dual-energy X-ray absorptiometry and history of fragility fracture was determined in 75 T1D participants with ≥50 years of diabetes duration and 75 age- and sex-matched non-diabetic controls. BMD T-scores were determined for the lumbar spine (LS), total hip (TH) and femoral neck (FN).ResultsT1D participants had median diabetes duration of 54 [52, 58] years, 41 (55%) were females, and mean A1c was 7.3 ± 0.8%. T1D females had higher LS T-scores compared to female controls (?0.3 ± 1.2 vs. ?1.1 ± 1.4, p = 0.014), lower FN T-scores (?1.5 ± 1.0 vs. ?1.2 ± 0.9, p = 0.042) and more fragility fractures (7 (17%) vs. 1 (2%), p = 0.021). In T1D, higher A1c was associated with higher adjusted odds of fragility fracture (p = 0.006). T1D males and controls showed no difference in BMD or fractures.ConclusionsThere were no substantial differences in T-score between T1D and matched controls; however, T1D females showed higher BMD at the LS and possibly paradoxically higher fragility fractures compared to matched controls. These findings suggest that lower T-scores may not be associated with a history of fragility fracture in females with longstanding T1D and that other factors should be investigated. |
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| Keywords: | Corresponding author at: Endocrinology and Metabolism, Department of Medicine, University of Toronto Lunenfeld-Tanenbaum Research Institute, Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, L5209-60 Murray Street Box 16, Toronto, Ontario M5T3L9, Canada. Bone Bone mineral density Fragility fracture Type 1 diabetes Diabetes complications |
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