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Bone mass and strength in older men with type 2 diabetes: The Osteoporotic Fractures in Men Study
Authors:Moira A Petit  Misti L Paudel  Brent C Taylor  Julie M Hughes  Elsa S Strotmeyer  Ann V Schwartz  Jane A Cauley  Joseph M Zmuda  Andrew R Hoffman  Kristine E Ensrud
Affiliation:1. School of Kinesiology, Laboratory for Musculoskeletal Health, University of Minnesota, Minneapolis, MN, USA;2. Division of Epidemiology, University of Minnesota, Minneapolis, MN, USA;3. Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MN, USA;4. Department of Medicine, University of Minnesota, Minneapolis, MN, USA;5. Division of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA;6. Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA;7. VA Palo Alto Health Care System and Division of Endocrinology, Stanford University, Palo Alto, CA, USA
Abstract:The effects of type 2 diabetes mellitus (T2DM) on bone volumetric density, bone geometry, and estimates of bone strength are not well established. We used peripheral quantitative computed tomography (pQCT) to compare tibial and radial bone volumetric density (vBMD, mg/cm3), total (ToA, mm2) and cortical (CoA, mm2) bone area and estimates of bone compressive and bending strength in a subset (n = 1171) of men (≥65 years of age) who participated in the multisite Osteoporotic Fractures in Men (MrOS) study. Analysis of covariance–adjusted bone data for clinic site, age, and limb length (model 1) and further adjusted for body weight (model 2) were used to compare data between participants with (n = 190) and without (n = 981) T2DM. At both the distal tibia and radius, patients with T2DM had greater bone vBMD (+2% to +4%, model 1, p < .05) and a smaller bone area (ToA ?1% to ?4%, model 2, p < .05). The higher vBMD compensated for lower bone area, resulting in no differences in estimated compressive bone strength at the distal trabecular bone regions. At the mostly cortical bone midshaft sites of the radius and tibia, men with T2DM had lower ToA (?1% to ?3%, p < .05), resulting in lower bone bending strength at both sites after adjusting for body weight (?2% to ?5%, p < .05) despite the lack of difference in cortical vBMD at these sites. These data demonstrate that older men with T2DM have bone strength that is low relative to body weight at the cortical‐rich midshaft of the radius despite no difference in cortical vBMD. © 2010 American Society for Bone and Mineral Research
Keywords:bone geometry  osteoporosis  peripheral quantitative computed tomography  diabetes mellitus
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