TY - JOUR
T1 - Vertebral Fractures in Type 2 Diabetes Patients
T2 - Utility of Trabecular Bone Score and Relationship With Serum Bone Turnover Biomarkers
AU - Lin, Yu Ching
AU - Wu, Jim
AU - Kuo, Sheng Fong
AU - Cheung, Yun Chung
AU - Sung, Chen Ming
AU - Fan, Chih Ming
AU - Chen, Fang Ping
AU - Mhuircheartaigh, Jennifer Ní
N1 - Publisher Copyright:
© 2019 The International Society for Clinical Densitometry
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Background: Patients with type 2 diabetes (T2D) have an increased risk for vertebral fracture (VF). The aim of this study is to determine the utility of trabecular bone score (TBS) in T2D patients with VF and the relationship of TBS with serum bone turnover biomarkers (SBTBs). Methodology: Postmenopausal T2D female patients were prospectively enrolled. All patients received: (1) dual-energy X-ray absorptiometry exam for bone mineral density (BMD), T-score, and TBS values; (2) lateral lumbar spine radiographs for VF assessment; and (3) SBTBs: bone specific alkaline phosphatase and Beta-C-Terminal telopeptides. BMD, T-score, TBS, and SBTBs were tested for association with VF. Results: The study included 285 T2D patients (mean age = 61.1 years) and 32 patients had VF (11.2%). TBS had the strongest association with VF in T2D patients (area under curve 0.775). The TBS cutoff values for VF are 1.279 in T-score ≥1 and 1.236 in T-score <−1. In patients without VF, all sites of BMD and TBS are significantly associated with SBTBs, but in patients with VF, no associations are found between SBTBs and all sites of BMD and TBS. Conclusions: TBS can assess bone quality in the spine. The low TBS cutoff values for T2D patients with VF imply T2D does impair bone quality. Thus, TBS should be incorporated in VF risk assessment in T2D patients. In addition, a dissociated relationship between BMD and TBS with SBTBs represents imbalanced bone turnover rate and results in bone fragility and VF.
AB - Background: Patients with type 2 diabetes (T2D) have an increased risk for vertebral fracture (VF). The aim of this study is to determine the utility of trabecular bone score (TBS) in T2D patients with VF and the relationship of TBS with serum bone turnover biomarkers (SBTBs). Methodology: Postmenopausal T2D female patients were prospectively enrolled. All patients received: (1) dual-energy X-ray absorptiometry exam for bone mineral density (BMD), T-score, and TBS values; (2) lateral lumbar spine radiographs for VF assessment; and (3) SBTBs: bone specific alkaline phosphatase and Beta-C-Terminal telopeptides. BMD, T-score, TBS, and SBTBs were tested for association with VF. Results: The study included 285 T2D patients (mean age = 61.1 years) and 32 patients had VF (11.2%). TBS had the strongest association with VF in T2D patients (area under curve 0.775). The TBS cutoff values for VF are 1.279 in T-score ≥1 and 1.236 in T-score <−1. In patients without VF, all sites of BMD and TBS are significantly associated with SBTBs, but in patients with VF, no associations are found between SBTBs and all sites of BMD and TBS. Conclusions: TBS can assess bone quality in the spine. The low TBS cutoff values for T2D patients with VF imply T2D does impair bone quality. Thus, TBS should be incorporated in VF risk assessment in T2D patients. In addition, a dissociated relationship between BMD and TBS with SBTBs represents imbalanced bone turnover rate and results in bone fragility and VF.
KW - Bone mineral density
KW - diabetes
KW - fracture risk
KW - serum bone turnover biomarkers
KW - trabecular bone score
UR - http://www.scopus.com/inward/record.url?scp=85061523408&partnerID=8YFLogxK
U2 - 10.1016/j.jocd.2019.01.003
DO - 10.1016/j.jocd.2019.01.003
M3 - 文章
C2 - 30773275
AN - SCOPUS:85061523408
SN - 1094-6950
VL - 23
SP - 37
EP - 43
JO - Journal of Clinical Densitometry
JF - Journal of Clinical Densitometry
IS - 1
ER -