Bone Histomorphometry in Young Patients With Type 2 Diabetes is Affected by Disease Control and Chronic Complications

Abstract Context Type 2 diabetes mellitus (T2DM) is associated with an increased risk of fractures. No study has evaluated the correlation of bone histomorphometry (BH) parameters with glycemic control and presence of chronic complications (CCs) in premenopausal women with T2DM. Objectives To evalua...

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Published in:The journal of clinical endocrinology and metabolism 2020-02, Vol.105 (2), p.506-514
Main Authors: Andrade, Vicente F C, Chula, Domingos C, Sabbag, Fábio P, Cavalheiro, Daniel D da S, Bavia, Lorena, Ambrósio, Altair Rogério, da Costa, Cleber Rafael V, dos Reis, Luciene M, Borba, Victória Z C, Aguiar Moreira, Carolina
Format: Article
Language:English
Subjects:
Apposition
Bone growth
Bone histomorphometry
Bones
Complications and side effects
Diabetes
Diabetes mellitus (non-insulin dependent)
Diabetes therapy
Disease control
Fractures
Health aspects
Hemoglobin
Insulin
Insulin-like growth factor I
Insulin-like growth factors
Osteogenesis
Osteoid
Pentosidine
Physiological aspects
Risk factors
Type 2 diabetes
Women
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Summary:Abstract Context Type 2 diabetes mellitus (T2DM) is associated with an increased risk of fractures. No study has evaluated the correlation of bone histomorphometry (BH) parameters with glycemic control and presence of chronic complications (CCs) in premenopausal women with T2DM. Objectives To evaluate BH and correlate them with the degree of glycemic control and presence of CCs. Design, settings, and patients This was a cross-sectional study conducted at a tertiary medical center. Twenty-six premenopausal women with T2DM were divided into groups with glycated hemoglobin HbA1c < 7% (good control, GC; n = 10) and HbA1c > 7% (poor control, PC; n = 16), and further subdivided into groups with (n = 9) and without (n = 17) CCs. BH parameters (bone volume [bone volume per total volume, BV/TV], trabecular thickness [Tb.Th], trabecular number [Tb.N], trabecular separation [Tb.Sp], osteoid thickness [O.Th], osteoid surface [osteoid surface per bone surface, OS/BS]), mineralizing surface [MS/BS], bone formation rate [BFR]), mineral apposition rate [MAR]) as well as serum pentosidine (PEN) and insulin-like growth factor (IGF)-1 were measured. The BH data were compared among the groups and with a BH control group (control group, CG, n = 15) matched by age, sex, and race. Results BV/TV was increased in GC (P < .001) and PC (P = .05) groups and O.th (P = .03) was smaller in the PC group than in the CG. A comparison of the groups with and without CCs with the CG showed in the group with CCs, O.Th was smaller(P = .01) and BV/TV similar to the CG (P = .11). HbA1c correlated negatively with O.Th (P = .02) and OS/BS (P = .01). There was no correlation of BH to PEN and IGF-1. Conclusion BH in premenopausal patients with T2DM is affected by disease control and chronic complications.
ISSN:0021-972X
1945-7197
DOI:10.1210/clinem/dgz070