|DAWSON-HUGHES, BESS - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
|BOUXSEIN, MARY - Harvard University|
|SHEA, KYLA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
Submitted to: Osteoporosis International
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/9/2019
Publication Date: 8/28/2019
Citation: Dawson-Hughes, B., Bouxsein, M., Shea, K. 2019. Bone material strength in normoglycemic and hyperglycemic black and white older adults. Osteoporosis International. 30:2429-2435. https://doi.org/10.1007/s00198-019-05140-1.
Interpretive Summary: Adults with type 2 diabetes have higher fracture rates than nondiabetics, but they also have higher bone mineral density. This suggests that bone strength is compromised in diabetes. This study was done to assess and compare bone mineral density and bone strength in older adults with normal blood sugar, with moderately elevated blood sugar (or prediabetes), and with frank type 2 diabetes. Two hundred men and women age 50 years and older participated. Bone strength was measured by a relatively new procedure, impact microindentation (known as BMSi), and the measurement was made in the lower leg. We found that among the white participants, there was no association of BMSi with blood sugar level, however, as shown in the past the participants with diabetes had higher bone mineral density than the others. In contrast, among the black participants, diabetes was associated with reduced bone strength. This study suggests that among adults with diabetes, blacks may be more susceptible to reduced bone strength than whites.
Technical Abstract: Purpose: Individuals with long-standing type 2 diabetes (T2D) have altered cortical bone material properties as determined by impact microindentation. This cross-sectional study was done to determine whether altered cortical bone material properties could be detected in adults with prediabetes or early stage T2D. Methods: Men and postmenopausal women aged greater than 50 years with no diabetes (50 white, 6 black), prediabetes (75 white, 13 black), and T2D of less than 5 years duration (24 white and 16 black) had assessments of bone material strength index (BMSi) by impact microindentation, trabecular bone score (TBS) and bone mineral density (BMD) by DXA, and the advanced glycation end product, urine pentosidine. Results: The association between glycemia category and BMSi differed by race (interaction p=0.037). In the whites, BMSi did not differ across the glycemia categories, after adjustment for age, sex, and BMI (no diabetes 76.3+/-1.6 (SEM); prediabetes 77.2+/-1.3; T2D 76.2+/-2.5, ANCOVA P=0.887). In contrast, in the blacks, BMSi differed (ANCOVA P=0.020) and was significantly lower in subjects with T2D than in those with prediabetes (P<0.05) and no diabetes (P<0.05) (mean SEM BMSi in no-diabetes 86.0+/-4.3; prediabetes 91.0+/-3.2; and T2D 71.6+/-2.9). Neither TBS nor urine pentosidine differed significantly across the glycemia categories in either whites or blacks. Conclusions: These findings suggest different associations of glycemia with cortical bone material properties in blacks and whites, with blacks possibly being more susceptible to impaired cortical bone properties than whites in early diabetes. A larger study is needed to verify these observations.