Article :: Bone mass and strength in older men with type 2 diabetes The Osteoporotic Fractures in Men Study

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Original Article

Bone mass and strength in older men with type 2 diabetes: The Osteoporotic Fractures in Men Study

Moira A Petit^{1 *}, Misti L Paudel², Brent C Taylor^{2 3 4}, Julie M Hughes¹, Elsa S Strotmeyer⁵, Ann V Schwartz⁶, Jane A Cauley⁵, Joseph M Zmuda⁵, Andrew R Hoffman⁷, Kristine E Ensrud^{2 3 4}, for the Osteoporotic Fractures in Men (MrOs) Study Group

¹School of Kinesiology, Laboratory for Musculoskeletal Health, University of Minnesota, Minneapolis, MN, USA
²Division of Epidemiology, University of Minnesota, Minneapolis, MN, USA
³Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MN, USA
⁴Department of Medicine, University of Minnesota, Minneapolis, MN, USA
⁵Division of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
⁶Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
⁷VA Palo Alto Health Care System and Division of Endocrinology, Stanford University, Palo Alto, CA, USA

email: Moira A Petit (mpetit@umn.edu)

^*Correspondence to Moira A Petit, Moira Petit, PhD, University of Minnesota, School of Kinesiology, 1900 University Ave., 111 Cooke Hall, Minneapolis, MN, USA.

Keywords

bone geometry osteoporosis peripheral quantitative computed tomography diabetes mellitus

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

Received: 16 September 2008; Revised: 13 February 2009; Accepted: 8 July 2009

Digital Object Identifier (DOI)

10.1359/jbmr.090725 About DOI