PMID- 20719835
OWN - NLM
STAT- MEDLINE
DCOM- 20101210
LR  - 20220409
IS  - 1945-7197 (Electronic)
IS  - 0021-972X (Print)
IS  - 0021-972X (Linking)
VI  - 95
IP  - 11
DP  - 2010 Nov
TI  - High-resolution peripheral quantitative computed tomographic imaging of cortical 
      and trabecular bone microarchitecture in patients with type 2 diabetes mellitus.
PG  - 5045-55
LID - 10.1210/jc.2010-0226 [doi]
AB  - CONTEXT: Cross-sectional epidemiological studies have found that patients with 
      type 2 diabetes mellitus (T2DM) have a higher incidence of certain fragility 
      fractures despite normal or elevated bone mineral density (BMD). OBJECTIVE: In 
      this study, high-resolution peripheral quantitative computed tomography was 
      applied to characterize cortical and trabecular microarchitecture and 
      biomechanics in the peripheral skeleton of female patients with T2DM. DESIGN AND 
      SETTING: A cross-sectional study was conducted in patients with T2DM recruited 
      from a diabetic outpatient clinic. PARTICIPANTS: Elderly female patients (age, 
      62.9 +/- 7.7 yr) with a history of T2DM (n = 19) and age- and height-matched 
      controls (n = 19) were recruited. OUTCOME MEASURES: Subjects were imaged using 
      high-resolution peripheral quantitative computed tomography at the distal radius 
      and tibia. Quantitative measures of volumetric (BMD), cross-sectional geometry, 
      trabecular and cortical microarchitecture were calculated. Additionally, 
      compressive mechanical properties were determined by micro-finite element 
      analysis. RESULTS: Compared to the controls, the T2DM cohort had 10% higher 
      trabecular volumetric BMD (P < 0.05) adjacent to the cortex and higher trabecular 
      thickness in the tibia (13.8%; P < 0.05). Cortical porosity differences alone 
      were consistent with impaired bone strength and were significant in the radius 
      (>+50%; P < 0.05), whereas pore volume approached significance in the tibia 
      (+118%; P = 0.1). CONCLUSION: The results of this pilot investigation provide a 
      potential explanation for the inability of standard BMD measures to explain the 
      elevated fracture incidence in patients with T2DM. The findings suggest that T2DM 
      may be associated with impaired resistance to bending loads due to inefficient 
      redistribution of bone mass, characterized by loss of intracortical bone offset 
      by an elevation in trabecular bone density.
FAU - Burghardt, Andrew J
AU  - Burghardt AJ
AD  - Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and 
      Biomedical Imaging, University of California, San Francisco, QB3 Building, Suite 
      203, San Francisco, California 94158, USA. andrew.burghardt@ucsf.edu
FAU - Issever, Ahi S
AU  - Issever AS
FAU - Schwartz, Ann V
AU  - Schwartz AV
FAU - Davis, Kevin A
AU  - Davis KA
FAU - Masharani, Umesh
AU  - Masharani U
FAU - Majumdar, Sharmila
AU  - Majumdar S
FAU - Link, Thomas M
AU  - Link TM
LA  - eng
GR  - R01 AG17762/AG/NIA NIH HHS/United States
GR  - RC1 AR058405-01/AR/NIAMS NIH HHS/United States
GR  - UL1 RR024131/RR/NCRR NIH HHS/United States
GR  - RC1 AR058405/AR/NIAMS NIH HHS/United States
GR  - R01 AG017762/AG/NIA NIH HHS/United States
GR  - UL1 RR024131-01/RR/NCRR NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20100818
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
SB  - IM
MH  - Aged
MH  - Analysis of Variance
MH  - Bone Density
MH  - Cross-Sectional Studies
MH  - Diabetes Mellitus, Type 2/*diagnostic imaging
MH  - Female
MH  - Finite Element Analysis
MH  - Humans
MH  - Image Processing, Computer-Assisted
MH  - Middle Aged
MH  - Pilot Projects
MH  - Radius/*diagnostic imaging
MH  - Tibia/*diagnostic imaging
MH  - Tomography, X-Ray Computed
PMC - PMC2968722
EDAT- 2010/08/20 06:00
MHDA- 2010/12/14 06:00
PMCR- 2011/11/01
CRDT- 2010/08/20 06:00
PHST- 2010/08/20 06:00 [entrez]
PHST- 2010/08/20 06:00 [pubmed]
PHST- 2010/12/14 06:00 [medline]
PHST- 2011/11/01 00:00 [pmc-release]
AID - jc.2010-0226 [pii]
AID - 7658 [pii]
AID - 10.1210/jc.2010-0226 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 2010 Nov;95(11):5045-55. doi: 10.1210/jc.2010-0226. Epub 
      2010 Aug 18.