Assessment of bone quality in patients with diabetes mellitus

AbstractSubstantial evidence exists that diabetes mellitus is associated with an increased risk of osteoporotic fractures. Low bone strength as well as bone extrinsic factors are probably contributing to the increased bone fragility in diabetes. Bone density and quality are important determinants of bone strength. Although bone mineral density (BMD) and the fracture risk assessment tool (FRAX) are very useful clinical tools in assessing bone strength, they may underestimate the fracture risk in diabetes mellitus. Through advances in new technologies such as trabecular bone score (TBS) and peripheral quantitative computed tomography (pQCT), we can better assess the bone quality and fracture risk of patients with diabetes mellitus. Invasive assessments such as microindentation and histomorphometry have been great complement to the existing bone analysis techniques. Bone turnover markers have been found to be altered in diabetes mellitus patients and may be associated with fractures. This review will give a brief summary of the current development and clinical uses of these assessments.
Source: Osteoporosis International - Category: Orthopaedics Source Type: research

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AbstractSummaryOpportunistic osteoporosis screening involves measuring the attenuation of L1 vertebrae on abdominal computed tomography (CT), which correlates with DXA T-score. We found that this approach is useful for detecting low bone mass in patients with diabetes and propose L1 attenuation ≤ 135 Hounsfield units (HU) as a threshold for which DXA should be strongly considered.IntroductionAttenuation of the L1 vertebrae on computer tomography (CT) images done for other reasons ( “Opportunistic Osteoporosis Screening”) has been found to correlate well with DXA-derived T-score. However, the method an...
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
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Source: Climacteric - Category: Geriatrics Authors: Tags: Climacteric Source Type: research
Rationale: Cases of adrenocortical hyperfunction combined with primary aldosteronism have been reported in the literature, and the underlying mechanism involves the secretion of aldosterone and glucocorticoids by a tumor or an adenoma. However, adrenocortical hypofunction and coexisting primary aldosteronism have not been reported until now. Herein, we report a case of adrenocortical hypofunction combined with primary aldosteronism. Patient concerns: A 66-year-old Chinese woman with rheumatoid arthritis who had been diagnosed with secondary adrenal insufficiency and was taking prednisone acetate tablets for replacemen...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
ConclusionsLower vBMD was associated with increased all-cause mortality in African-American men with T2D, independent of other risk factors for mortality including subclinical atherosclerosis.
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
Apelin-13 deficiency alters cortical bone geometry, organic bone matrix, and inhibits Wnt/β-catenin signaling. Gen Comp Endocrinol. 2018 May 29;: Authors: Han XF, Zhang XX, Liu KM, Zhang Q Abstract Adipokines play key roles in the regulation of obesity, type 2 diabetes mellitus, and bone growth. As a newly discovered hormone in the adipokines family, the precise role of Apelin-13 on bone metabolism is not yet clear. Apelin-13 and 25(OH)D3 expression were detected in freshly isolated serum of healthy individuals and osteoporosis patients with ELISA method. Apelin-13 deficient mice were set up and ...
Source: General and Comparative Endocrinology - Category: Endocrinology Authors: Tags: Gen Comp Endocrinol Source Type: research
AbstractIn a previous report of two married cohabiting couples affected by polymyalgia rheumatica (PMR), we noticed that the wife of one couple and both members of the other couple suffered from symptomatic diverticular disease (DD), whose diagnosis was made before the onset of PMR. We investigated whether DD might be a risk factor for the development of PMR. We conducted a case-control study informed on a database containing the prospectively collected medical records of consecutive PMR patients. Among comorbidities, attention was focused on symptomatic DD, provided that the diagnosis had been made by colonoscopy and/or c...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 62-year-old woman is evaluated for an incidentally discovered left adrenal mass. Two weeks ago, the patient was evaluated in the emergency department for diffuse abdominal pain and vomiting. A CT scan was obtained that was normal except for the adrenal mass. Three hours after presentation to the emergency department, the pain resolved spontaneously. Her medical history is significant for diet-controlled type 2 diabetes mellitus diagnosed 1 year ago and osteoporosis diagnosed 4 years ago. Her only medic...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Endocrinology Oncology/Hematology Source Type: blogs
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Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Diffuse Parenchymal Lung Disease Source Type: research
CONCLUSIONS: In non-diabetic, postmenopausal women, insulin resistance was associated with smaller bone size, greater volumetric bone mineral density and generally favorable bone microarchitecture at weight bearing and non-weight bearing skeletal sites. These associations were independent of body weight and other potential covariates, suggesting that hyperinsulinemia directly effects bone structure independent of obesity and may explain, in part, the higher trabecular bone density and favorable trabecular microarchitecture seen in individuals with type 2 diabetes mellitus. PMID: 27243136 [PubMed - as supplied by publisher]
Source: The Journal of Clinical Endocrinology and Metabolism - Category: Endocrinology Authors: Tags: J Clin Endocrinol Metab Source Type: research
Conclusion Our data suggest that volumetric bone parameters by QCT and serum sclerostin levels can identify T2D individuals at high risk of fracture and might therefore show promise as clinical tools for fracture risk assessment in T2D. However, future research is needed to establish diabetes-specific QCT- and sclerostin-reference databases.
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
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