Bone Tissue Composition in Postmenopausal Women Varies With Glycemic Control From Normal Glucose Tolerance to Type 2 Diabetes Mellitus.

Autor: Hunt HB; Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA., Miller NA; Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA., Hemmerling KJ; Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA., Koga M; Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA., Lopez KA; Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA., Taylor EA; Sibley School of Mechanical Engineering, Cornell University, Ithaca, NY, USA., Sellmeyer DE; Division of Endocrinology, Gerontology, and Metabolism, Stanford University School of Medicine, Palo Alto, CA, USA., Moseley KF; Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Donnelly E; Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA.; Research Division, Hospital for Special Surgery, New York, NY, USA.
Jazyk: angličtina
Zdroj: Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research [J Bone Miner Res] 2021 Feb; Vol. 36 (2), pp. 334-346. Date of Electronic Publication: 2020 Oct 29.
DOI: 10.1002/jbmr.4186
Abstrakt: The risk of fragility fracture increases for people with type 2 diabetes mellitus (T2DM), even after controlling for bone mineral density, body mass index, visual impairment, and falls. We hypothesize that progressive glycemic derangement alters microscale bone tissue composition. We used Fourier-transform infrared (FTIR) imaging to analyze the composition of iliac crest biopsies from cohorts of postmenopausal women characterized by oral glucose tolerance testing: normal glucose tolerance (NGT; n = 35, age = 65 ± 7 years, HbA1c = 5.8 ± 0.3%), impaired glucose tolerance (IGT; n = 26, age = 64 ± 5 years, HbA1c = 6.0 ± 0.4%), and overt T2DM on insulin (n = 25, age = 64 ± 6 years, HbA1c = 9.13 ± 0.6). The distributions of cortical bone mineral content had greater mean values (+7%) and were narrower (-10%) in T2DM versus NGT groups (p < 0.05). The distributions of acid phosphate, an indicator of new mineral, were narrower in cortical T2DM versus NGT and IGT groups (-14% and -14%, respectively) and in trabecular NGT and IGT versus T2DM groups (-11% and -10%, respectively) (all p < 0.05). The distributions of crystallinity were wider in cortical NGT versus T2DM groups (+16%) and in trabecular NGT versus T2DM groups (+14%) (all p < 0.05). Additionally, bone turnover was lower in T2DM versus NGT groups (P1NP: -25%, CTx: -30%, ucOC: -24%). Serum pentosidine was similar across groups. The FTIR compositional and biochemical marker values of the IGT group typically fell between the NGT and T2DM group values, although the differences were not always statistically significant. In summary, worsening glycemic control was associated with greater mineral content and narrower distributions of acid phosphate, an indicator of new mineral, which together are consistent with observations of lower turnover; however, wider distributions of mineral crystallinity were also observed. A more mineralized, less heterogeneous tissue may affect tissue-level mechanical properties and in turn degrade macroscale skeletal integrity. In conclusion, these data are the first evidence of progressive alteration of bone tissue composition with worsening glycemic control in humans. © 2020 American Society for Bone and Mineral Research (ASBMR).
(© 2020 American Society for Bone and Mineral Research (ASBMR).)
Databáze: MEDLINE
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