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Conference Paper: Bone quality in Chinese postmenopausal women with type 2 diabetes mellitus: a cross-sectional study

TitleBone quality in Chinese postmenopausal women with type 2 diabetes mellitus: a cross-sectional study
Authors
Issue Date2019
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/
Citation
24th Medical Research Conference, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, 19 January 2019. In Hong Kong Medical Journal, 2019, v. 25 n. 1, Suppl. 1, p. 29, abstract no. 40 How to Cite?
AbstractIntroduction: Type 2 diabetes mellitus (T2DM) is associated with 1.34-fold increase in hip fracture risk despite higher bone mineral density (BMD). Trabecular bone score (TBS), an indirect index of bone microarchitecture based on lumbar spine image on dual-energy X-ray absorptiometry, captures a larger portion of T2DM-related fracture risk. Here we compared the bone quality in Chinese postmenopausal women with T2DM with those without diabetes mellitus (non-DM). Methods: We conducted a cross-sectional study of postmenopausal women, with T2DM patients recruited from the Hong Kong West Diabetes Registry and non-DM patients from the Hong Kong Cardiovascular Risk Factor Prevalence Study, between November 2016 and October 2018. Type 2 diabetes was defined by fasting glucose ≥7.0 mmol/L, 2-hour oral glucose tolerance test (OGTT) ≥11.0 mmol/L, or glycated haemoglobin (HbA1c) ≥6.5%; pre-diabetes (pre-DM) by fasting glucose 5.6-6.9 mmol/L, 2-hour OGTT 7.8-11.0 mmol/L, or HbA1c 5.7% to 6.4%; and euglycaemia by normal fasting glucose, 2-hour OGTT, and HbA1c. Bone mineral density, vertebral fracture assessment, and TBS were measured by dual energy X-ray absorptiometry. Results: A total of 322 patients (104 with T2DM, 218 non-DM) were included. Compared with non-DM patients, those with T2DM were older (63.7 vs 62.1 years, P=0.012) and heavier (25.6 vs 23.2 kg/m2 , P=0.002), and had higher lumbar spine BMD (0.93 vs 0.85 g/cm2 , P<0.001) but lower TBS (1.28 vs 1.26, P=0.031). Vertebral fractures were more prevalent in patients with T2DM and pre-DM compared with those with euglycaemia (P=0.03). Multivariable linear regression analysis revealed that TBS was significantly lower in patients with T2DM compared with non-DM patients, after adjustment for age, body mass index, and lumbar spine BMD (P<0.001). Trabecular bone score showed a significant decreasing trend with worsening glycaemic status after adjusting for covariates (1.30, 1.27 and 1.26 in patients with euglycaemia, pre-DM and T2DM, respectively, P=0.001). Subgroup analysis revealed that among patients aged ≥60 years, TBS was significantly lower in patients with preDM than in those with euglycaemia (P=0.020), but similar to that in patients with T2DM (P=0.206). Conclusion: In Chinese postmenopausal women, T2DM is associated with higher BMD, but lower TBS compared with non-DM. Trabecular bone score decreases with worsening glycaemic status. Lower TBS with more vertebral fractures can be observed starting from pre-DM in older age-group, suggesting potential impact of early intervention of pre-DM from the perspective of bone health, which warrants further studies.
Persistent Identifierhttp://hdl.handle.net/10722/300823
ISSN
2020 Impact Factor: 2.227
2020 SCImago Journal Rankings: 0.357

 

DC FieldValueLanguage
dc.contributor.authorLui, TWD-
dc.contributor.authorChau, VWK-
dc.contributor.authorFong, CHY-
dc.contributor.authorYeung, KMY-
dc.contributor.authorLam, KSL-
dc.contributor.authorWoo, YC-
dc.date.accessioned2021-07-06T03:10:43Z-
dc.date.available2021-07-06T03:10:43Z-
dc.date.issued2019-
dc.identifier.citation24th Medical Research Conference, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, 19 January 2019. In Hong Kong Medical Journal, 2019, v. 25 n. 1, Suppl. 1, p. 29, abstract no. 40-
dc.identifier.issn1024-2708-
dc.identifier.urihttp://hdl.handle.net/10722/300823-
dc.description.abstractIntroduction: Type 2 diabetes mellitus (T2DM) is associated with 1.34-fold increase in hip fracture risk despite higher bone mineral density (BMD). Trabecular bone score (TBS), an indirect index of bone microarchitecture based on lumbar spine image on dual-energy X-ray absorptiometry, captures a larger portion of T2DM-related fracture risk. Here we compared the bone quality in Chinese postmenopausal women with T2DM with those without diabetes mellitus (non-DM). Methods: We conducted a cross-sectional study of postmenopausal women, with T2DM patients recruited from the Hong Kong West Diabetes Registry and non-DM patients from the Hong Kong Cardiovascular Risk Factor Prevalence Study, between November 2016 and October 2018. Type 2 diabetes was defined by fasting glucose ≥7.0 mmol/L, 2-hour oral glucose tolerance test (OGTT) ≥11.0 mmol/L, or glycated haemoglobin (HbA1c) ≥6.5%; pre-diabetes (pre-DM) by fasting glucose 5.6-6.9 mmol/L, 2-hour OGTT 7.8-11.0 mmol/L, or HbA1c 5.7% to 6.4%; and euglycaemia by normal fasting glucose, 2-hour OGTT, and HbA1c. Bone mineral density, vertebral fracture assessment, and TBS were measured by dual energy X-ray absorptiometry. Results: A total of 322 patients (104 with T2DM, 218 non-DM) were included. Compared with non-DM patients, those with T2DM were older (63.7 vs 62.1 years, P=0.012) and heavier (25.6 vs 23.2 kg/m2 , P=0.002), and had higher lumbar spine BMD (0.93 vs 0.85 g/cm2 , P<0.001) but lower TBS (1.28 vs 1.26, P=0.031). Vertebral fractures were more prevalent in patients with T2DM and pre-DM compared with those with euglycaemia (P=0.03). Multivariable linear regression analysis revealed that TBS was significantly lower in patients with T2DM compared with non-DM patients, after adjustment for age, body mass index, and lumbar spine BMD (P<0.001). Trabecular bone score showed a significant decreasing trend with worsening glycaemic status after adjusting for covariates (1.30, 1.27 and 1.26 in patients with euglycaemia, pre-DM and T2DM, respectively, P=0.001). Subgroup analysis revealed that among patients aged ≥60 years, TBS was significantly lower in patients with preDM than in those with euglycaemia (P=0.020), but similar to that in patients with T2DM (P=0.206). Conclusion: In Chinese postmenopausal women, T2DM is associated with higher BMD, but lower TBS compared with non-DM. Trabecular bone score decreases with worsening glycaemic status. Lower TBS with more vertebral fractures can be observed starting from pre-DM in older age-group, suggesting potential impact of early intervention of pre-DM from the perspective of bone health, which warrants further studies.-
dc.languageeng-
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/-
dc.relation.ispartofHong Kong Medical Journal-
dc.relation.ispartof24th Medical Research Conference, 2019-
dc.rightsHong Kong Medical Journal. Copyright © Hong Kong Academy of Medicine Press.-
dc.titleBone quality in Chinese postmenopausal women with type 2 diabetes mellitus: a cross-sectional study-
dc.typeConference_Paper-
dc.identifier.emailLui, TWD: dtwlui@hku.hk-
dc.identifier.emailChau, VWK: chauwk3@hku.hk-
dc.identifier.emailLam, KSL: ksllam@hku.hk-
dc.identifier.emailWoo, YC: wooyucho@hku.hk-
dc.identifier.authorityLui, TWD=rp02803-
dc.identifier.authorityLam, KSL=rp00343-
dc.description.natureabstract-
dc.identifier.hkuros323153-
dc.identifier.volume25-
dc.identifier.issue1, Suppl. 1-
dc.identifier.spage29, abstract no. 40-
dc.identifier.epage29, abstract no. 40-
dc.publisher.placeHong Kong-

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