Bone health in subjects with type 1 diabetes for more than 50 years.
Authors Maddaloni E, D'Eon S, Hastings S, Tinsley LJ, Napoli N, Khamaisi M, Bouxsein ML,
Fouda SM, Keenan HA
Submitted By Hillary Keenan on 4/3/2017
Status Published
Journal Acta diabetologica
Year 2017
Date Published
Volume : Pages Not Specified : Not Specified
PubMed Reference 28236093
Abstract Few data regarding prevalence of and risk factors for poor bone health in aging
individuals with long-standing T1D are available. In this study, we aim to
describe the prevalence of bone fragility and to identify factors associated
with low bone density in individuals with long-term T1D., We examined the
prevalence of non-vertebral fractures in 985 subjects enrolled in the Joslin
50-Year Medalist Study and measured bone mineral density (BMD) by dual-energy
X-ray absorptiometry at the femoral neck, lumbar spine and radius in a subset
(65 subjects, mean age 62.6 years, duration 52.5 years, HbA1c 7.1%) with no
significant clinical or demographic differences from the rest of the cohort.,
Medalists have low prevalence of fractures (0.20% hip and 0.91% wrist) and
normal Z-score values (spine +1.15, total hip +0.23, femoral neck -0.01, radius
+0.26; p > 0.05 for differences vs. 0 at all sites). A significant relationship
was found between lower BMD and higher total cholesterol, triglycerides and LDL
levels, but not HbA1c. Low BMD at the femoral neck was associated with
cardiovascular disease after adjustment for confounding factors: prevalence risk
ratio of CVD [95% CI] 4.6 [1.2-18.1], p = 0.03. No other diabetic vascular
complication was found to be associated with low BMD., These are the first data
regarding bone health in aging individuals who have had diabetes for 50 or more
years. The low rates of non-vertebral fractures and the normal Z-score suggest
the long T1D diabetes duration did not increase the risk of bone fractures in
Medalists compared to non-diabetic peers. Additionally, the association with
cardiovascular disease demonstrates the BMD differences in groups are likely not
due to glycemic control alone.

Investigators with authorship
Hillary KeenanJoslin Diabetes Center - Boston