PMID- 22726843
OWN - NLM
STAT- MEDLINE
DCOM- 20130123
LR  - 20211021
IS  - 1532-8600 (Electronic)
IS  - 0026-0495 (Print)
IS  - 0026-0495 (Linking)
VI  - 61
IP  - 12
DP  - 2012 Dec
TI  - Hip geometry in diabetic women: implications for fracture risk.
PG  - 1756-62
LID - S0026-0495(12)00197-7 [pii]
LID - 10.1016/j.metabol.2012.05.010 [doi]
AB  - OBJECTIVE: Women with type 2 diabetes mellitus (T2DM) have a higher risk of 
      fractures despite increased bone mineral density (BMD) as compared to women 
      without diabetes. We hypothesized that bone strength is diminished in women with 
      T2DM after accounting for lean body mass, which may contribute to their increased 
      fracture risk. METHODS: Participants from Women's Health Initiative Observational 
      Study were included in this cross-sectional study. These analyses include 3 
      groups of women: 1) T2DM women on diet or oral hypoglycemic agents (n=299); 2) 
      T2DM women on insulin therapy (with or without oral agents) (n=128); and 3) 
      Non-diabetic control women (n=5497). Hip structural analyses were done using the 
      validated Beck's method on hip scans from dual energy x-ray absorptiometry (DXA). 
      We compared BMD and section modulus (bending strength) at the narrow neck with 
      and without correcting for total body DXA lean body mass. RESULTS: Women in all 
      three groups were of similar ages (63.7, 64.6 and 64.2 years, respectively) and 
      heights, but those with T2DM were heavier, with greater lean body weight vs 
      controls (P<.001). In both diabetic groups, absolute BMD and section modulus were 
      higher compared with controls. However, after adjusting for total lean body 
      weight, diabetic women on insulin had significantly lower BMD and section 
      modulus. CONCLUSION: Adjusted for lean body weight, the BMD and bending strength 
      in the femoral neck are significantly lower in insulin-treated diabetic women vs 
      controls. This may represent altered adaptation of bone modeling and explain the 
      higher fracture risk in patients with T2DM.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Garg, Rajesh
AU  - Garg R
AD  - Brigham and Women's Hospital, Boston, MA 02115, USA.
FAU - Chen, Zhao
AU  - Chen Z
FAU - Beck, Thomas
AU  - Beck T
FAU - Cauley, Jane A
AU  - Cauley JA
FAU - Wu, Guanglin
AU  - Wu G
FAU - Nelson, Dorothy
AU  - Nelson D
FAU - Lewis, Beth
AU  - Lewis B
FAU - LaCroix, Andrea
AU  - LaCroix A
FAU - LeBoff, Meryl S
AU  - LeBoff MS
LA  - eng
GR  - HHSN268201100001I/HL/NHLBI NIH HHS/United States
GR  - HHSN268201100004I/HL/NHLBI NIH HHS/United States
GR  - HHSN268201100046C/HL/NHLBI NIH HHS/United States
GR  - HHSN268201100003C/WH/WHI NIH HHS/United States
GR  - HHSN271201100004C/AG/NIA NIH HHS/United States
GR  - HHSN268201100002C/WH/WHI NIH HHS/United States
GR  - HHSN268201100003I/HL/NHLBI NIH HHS/United States
GR  - HHSN268201100002I/HL/NHLBI NIH HHS/United States
GR  - HHSN268201100001C/WH/WHI NIH HHS/United States
GR  - HHSN268201100004C/WH/WHI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20120620
PL  - United States
TA  - Metabolism
JT  - Metabolism: clinical and experimental
JID - 0375267
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Absorptiometry, Photon
MH  - Aged
MH  - Body Composition
MH  - *Bone Density
MH  - Bone Remodeling
MH  - Cross-Sectional Studies
MH  - Diabetes Mellitus, Type 2/complications/*pathology/*physiopathology/therapy
MH  - Diet, Diabetic
MH  - Female
MH  - Femoral Neck Fractures/etiology/*pathology/*physiopathology
MH  - Femur Neck/*pathology/*physiopathology
MH  - Humans
MH  - Hypoglycemic Agents/administration & dosage
MH  - Middle Aged
MH  - Postmenopause
MH  - Risk Assessment
MH  - Risk Factors
MH  - Tensile Strength
MH  - Women's Health
PMC - PMC3459306
MID - NIHMS380482
COIS- Disclosure Statement: TB is co-founder of Quantum Medical metrics LLC which is 
      developing technology and software for evaluating bone structure. His former 
      employer, the Johns Hopkins University receives royalties from Hologic Inc. on 
      the HSA software used in this study with a share to TB. Other authors have no 
      conflict of interest.
EDAT- 2012/06/26 06:00
MHDA- 2013/01/24 06:00
PMCR- 2013/12/01
CRDT- 2012/06/26 06:00
PHST- 2012/01/05 00:00 [received]
PHST- 2012/04/20 00:00 [revised]
PHST- 2012/05/16 00:00 [accepted]
PHST- 2012/06/26 06:00 [entrez]
PHST- 2012/06/26 06:00 [pubmed]
PHST- 2013/01/24 06:00 [medline]
PHST- 2013/12/01 00:00 [pmc-release]
AID - S0026-0495(12)00197-7 [pii]
AID - 10.1016/j.metabol.2012.05.010 [doi]
PST - ppublish
SO  - Metabolism. 2012 Dec;61(12):1756-62. doi: 10.1016/j.metabol.2012.05.010. Epub 
      2012 Jun 20.