Symposium



Longitudinal Bone Quality Assessment in Patients with Type-2 Diabetes by HR-pQCT


Presenting Author Senior Author
Name: Courtney Pasco Name: Galateia Kazakia
Email: courtneyrae23@berkeley.edu Email: galateia.kazakia@ucsf.edu
Presenting Author’s RIG/SRG: Musculoskeletal  
Presenting Author's Lab Location: China Basin   

Abstract Information
Imaging Modality: CT
Disease Application: Musculoskeletal
Complete author list: Courtney Pasco, Nhan Dinh, Thomas Link, Ursula Heilmeier, Galateia Kazakia
Abstract highlights: Longitudinal bone quality changes in type-2 diabetic postmenopausal women with and without history of fragility fractures (DM, DMFx) were assessed using HR-pQCT and compared to non-diabetic postmenopausal women (controls). At the ultradistal tibia, cortical pore volume and cortical porosity increased at a faster rate in DMFx as compared to controls.
 
Introduction
Individuals with type 2 diabetes (T2D) are at increased risk of fragility fractures despite normal to high bone density. Our group has reported that elevated cortical porosity in type-2 diabetic postmenopausal women with history of fragility fractures may account for this higher fracture risk. However, it is unclear why, at what rate, and to what extent these cortical pores progress in T2D. The aim of this study was, therefore, to longitudinally assess bone microarchitecture and in particular cortical porosity in type-2 diabetic postmenopausal women with and without history of fragility fractures (DMFx, DM) and to compare their changes to those in non-diabetic postmenopausal women (CO).
 
Methods
Seventeen women (age 58.7 ± 5.7 years at baseline) were recruited into one of the three groups (DMFx: n=3, DM: n=8, CO: n=6). All patients underwent high-resolution peripheral quantitative computed tomography (HR-pQCT) scanning at their baseline and follow-up visits (on average 4.6 ± .7 years apart). Scan sites comprised the ultra-distal and distal radius and tibia. Analyzing the HR-pQCT data, changes in volumetric bone mineral density and cortical and trabecular structure measures, including cortical porosity, were calculated. Data were adjusted to account for the differing lengths of time between baseline and follow-up scans among cohorts. Statistical tests included Student-tests with adjustment for multiple comparisons.
 
Results
At the ultra-distal tibia, cortical pore volume and cortical porosity were found to increase at a faster rate in DMFx as compared to CO (p =0.041, p = 0.044, respectively, Figure).
 
Conclusions
Our findings of increased rates of cortical pore development in patients with T2D with history of fracture suggest that there may be a different form of T2D that more aggressively degrades bone and contributes to higher fracture risk.