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Open Access Research article

Changes in trabecular bone microarchitecture in postmenopausal women with and without type 2 diabetes: a two year longitudinal study

Janet M Pritchard1, Lora M Giangregorio2, Stephanie A Atkinson3, Karen A Beattie4, Dean Inglis5, George Ioannidis4, Hertzel Gerstein6, Zubin Punthakee6, Jonathan D Adachi4 and Alexandra Papaioannou6*

Author Affiliations

1 Faculty of Health Sciences, McMaster University, 1280 Main St West, Hamilton, ON L8S 4K1, Canada

2 Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada

3 Department of Pediatrics, McMaster University, 1280 Main St West, Hamilton, ON L8S 4K1, Canada

4 Department of Medicine, McMaster University, Charlton Medical Centre, 501-25 Charlton Ave E, Hamilton, ON L8N 1Y2, Canada

5 Department of Civil Engineering, McMaster University, 1280 Main St West, Hamilton, ON L8S 4K1, Canada

6 Department of Medicine, McMaster University, 1280 Main St West, Hamilton, ON L8S 4K1, Canada

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BMC Musculoskeletal Disorders 2013, 14:114  doi:10.1186/1471-2474-14-114

Published: 27 March 2013

Abstract

Background

The risk of experiencing an osteoporotic fracture is greater for adults with type 2 diabetes despite higher than normal bone mineral density (BMD). In addition to BMD, trabecular bone microarchitecture contributes to bone strength, but is not assessed using conventional BMD measurement by dual x-ray absorptiometry (DXA). The aim of this study was to compare two year changes in trabecular bone microarchitecture in women with and without type 2 diabetes.

Methods

We used a 1 Tesla magnetic resonance imaging (MRI) scanner to acquire axial images (resolution 195 μm × 195 μm × 1000 μm) of the distal radius. We report the change in the number and size of trabecular bone holes, bone volume fraction (BVTV), trabecular thickness (Tb.Th), number (Tb.N) and separation (Tb.Sp), endosteal area, nodal and branch density for each group. Lumbar spine and proximal femur BMD were measured with DXA (Hologic, Discovery QDR4500A) at baseline and follow-up. Using a multivariable linear regression model, we evaluated whether the percent change in the trabecular bone microarchitecture variables differed between women with and without type 2 diabetes.

Results

Of the 54 participants at baseline with valid MRI image sets, 37 participants (baseline mean [SD] age, 70.8 [4.4] years) returned for follow-up assessment after 25.4 [1.9] months. Lumbar spine BMD was greater for women with diabetes compared to without diabetes at both baseline and follow-up. After adjustment for ethnicity, women with diabetes had a higher percent increase in number of trabecular bone holes compared to controls (10[1] % versus −7 [2]%, p=0.010), however results were no longer significant after adjustment for multiple comparisons (p=0.090). There were no differences in the change in other trabecular bone microarchitecture variables between groups.

Conclusion

There were no differences in percent change in trabecular bone microarchitecture variables over two years in women with type 2 diabetes compared to women without diabetes. This study provides feasibility data, which will inform future trials assessing change in trabecular bone microarchitecture in women with type 2 diabetes. Larger studies using higher resolution imaging modalities that can assess change in trabecular and cortical bone compartments in women with type 2 diabetes are needed.