Similarities in trabecular hypertrophy with site-specific differences in cortical morphology between men and women with type 2 diabetes mellitus

• Published in: PloS one 2017-04, Vol.12 (4), p.e0174664-e0174664
• Main Authors: Patsch, Janina M, Rasul, Sazan, Huber, Florian A, Leitner, Karoline, Thomas, Anita, Kocijan, Roland, Boutroy, Stephanie, Weber, Michael, Resch, Heinrich, Kainberger, Franz, Schüller-Weidekamm, Claudia, Kautzky-Willer, Alexandra
• Format: Article
• Language: English
• Subjects: Age; Aged; Autoimmune diseases; Biology and Life Sciences; Bone Density; Bone diseases; Bone mineral density; Case-Control Studies; Collinearity; Complications and side effects; Computed tomography; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - pathology; Endocrinology; Female; Gastroenterology; Gender differences; Geometry; Health aspects; Hospitals; Humans; Hypertrophy; Immunology; Internal medicine; Male; Medical imaging; Medicine; Medicine and Health Sciences; Men; Metabolism; Middle Aged; Morphology; Pediatrics; Physical Sciences; Population; Quality; Quantitative analysis; Radius - diagnostic imaging; Radius - pathology; Researchers; Rheumatology; Risk factors; Sex differences (Biology); Sexes; Studies; Thickness; Tibia; Tibia - diagnostic imaging; Tibia - pathology; Tomography; Tomography, X-Ray Computed; Type 2 diabetes; Women; Womens health; Young adults
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0174664

The goal of our study was to investigate interactions between sex and type 2 diabetes mellitus (T2DM) with regard to morphology of the peripheral skeleton. We recruited 85 subjects (mean age, 57±11.4 years): women with and without T2DM (n = 17; n = 16); and men with and without T2DM (n = 26; n = 26). All patients underwent high-resolution, peripheral, quantitative, computed tomography (HR-pQCT) imaging of the ultradistal radius (UR) and tibia (UT). Local bone geometry, bone mineral density (BMD), and bone microarchitecture were obtained by quantitative analysis of HR-pQCT images. To reduce the amount of data and avoid multi-collinearity, we performed a factor-analysis of HR-pQCT parameters. Based on factor weight, trabecular BMD, trabecular number, cortical thickness, cortical BMD, and total area were chosen for post-hoc analyses. At the radius and tibia, diabetic men and women exhibited trabecular hypertrophy, with a significant positive main effect of T2DM on trabecular number. At the radius, cortical thickness was higher in diabetic subjects (+20.1%, p = 0.003). Interestingly, there was a statistical trend that suggested attenuation of tibial cortical hypertrophy in diabetic men (cortical thickness, pinteraction = 0.052). Moreover, we found an expected sexual dichotomy, with higher trabecular BMD, Tb.N, cortical BMD, Ct.Th, and total area in men than in women (p≤ 0.003) at both measurement sites. Our results suggest that skeletal hypertrophy associated with T2DM is present in men and women, but appears attenuated at the tibial cortex in men.