Bone Loss in Women with Type 1 Diabetes
- 1 Department of Endocrinology I, Bispebjerg University Hospital, Copenhagen, Denmark
- 2 Steno Diabetes Center, Gentofte, Denmark
- 3 Department of Endocrinology I, Bispebjerg University Hospital, Copenhagen, Denmark
- 4 Center for Clinical and Basic Research, Ballerup, Denmark
Abstract
Background: Although osteoporosis has been investigated and debated in the diabetic population over the past decades, very little is known about the spontaneous changes in bone mineral density (BMD) and biochemical markers of bone turnover in pre- and postmenopausal type 1 diabetic (T1DM) women over time. Aim: To measure spontaneous changes in BMD and biochemical markers of bone turnover in pre- and postmenopausal T1DM women. Subjects: 53 T1DM women (31 premenopausal and 22 postmenopausal) from the outpatient clinic were enrolled in the study in 1993 and 35 (22 premenopausal, 13 postmenopausal) were reexamined in 1997. Method: BMD was measured at femoral neck (f.n.), spine (L 2 - L 4 ), total body and forearm with DXA or SXA in 53 T1DM women. 4 years later a re-scan was carried out on 35 T1DM. Results: In premenopausal subjects a yearly decrease less than 1% at f.n., spine, forearm and total body was observed, though only statistically significant (s.s.) at f.n., p ≤ 0.05. In postmenopausal subjects a s.s. decrease less than 2% was observed at f.n., forearm and total body, p ≤ 0.05. In general, osteopenic or osteoporotic values were observed at the measured skeletal sites. Only at f.n. a lower s.s. BMD compared to age-matched reference women was seen. Conclusion: Small or non-significant changes in BMD and biochemical markers of bone turnover were observed in pre- and postmenopausal T1DM subjects after a 4-year period.
- Kanis, J.A. and the WHO Study Group (1994) Assessment of Fracture Risk and Its Application to Screening for Postmenopausal Osteoporosis: Synopsis of a WHO Report. Osteoporosis International, 4, 368-381. http://dx.doi.org/10.1007/BF01622200
- Albright, F.A. (1941) Postmenopausal Osteoporosis. JAMA, 116, 2465-2474. http://dx.doi.org/10.1001/jama.1941.02820220007002
- Gallacher, S.J., Fenner, J.A.K., Fisher, B.M., et al. (1993) An Evaluation and Bone Density and Turnover in Premenopausale Women with Type 1 Diabetes Mellitus. Diabetic Medicine, 10, 129-133. http://dx.doi.org/10.1111/j.1464-5491.1993.tb00029.x
- Lunt, H., Florkowski, C.M., Cundy, T., et al. (1998) A Population-Based Study of Bone Mineral Density in Women with Longstanding Type 1 (Insulin-Dependent) Diabetes. Diabetes Research and Clinical Practice, 40, 31-38. http://dx.doi.org/10.1016/S0168-8227(98)00012-6
- Giacca, A., Fassina, A., Caviezel, F., et al. (1988) Bone Mineral Density in Diabetes Mellitus. Bone, 9, 29-36. http://dx.doi.org/10.1016/8756-3282(88)90024-5
- Ingberg, C.M., Palmer, M., Aman, J., et al. (2004) Body Composition and Bone Mineral Density in Long-Standing Type 1 Diabetes. Journal of Internal Medicine, 255, 392-398. http://dx.doi.org/10.1046/j.1365-2796.2003.01283.x
- Rakic, V., Davis, W.A., Chubb, S.A.P., et al. (2006) Bone Mineral Density and Its Determinants in Diabetes: The Fremantle Diabetes Study. Diabetologia, 49, 863-871. http://dx.doi.org/10.1007/s00125-006-0154-2
- Rachon, D., Mysliwska, J., Suchecka-Rachon, K., et al. (2003) Serum Interleukin-6 Levels and Bone Mineral Density at the Femoral Neck in Post-Menopausal Women with Type 1 Diabetes. Diabetic Medicine, 20, 475-480. http://dx.doi.org/10.1046/j.1464-5491.2003.00953.x
- Compston, J.E., Smith, E.M., Matthews, C., et al. (1994) Whole Body Composition and Regional Bone Mass in Women with Insulin-Dependent Diabetes Mellitus. Clinical Endocrinology (Oxford), 41, 289-293. http://dx.doi.org/10.1111/j.1365-2265.1994.tb02547.x
- Miazgowski, T. and Czekalski, S. (1998) A 2-Year Follow-Up Study on Bone Mineral Density and Markers of Bone Turnover in Patients with Long-Standing Insulin-Dependent Diabetes Mellitus. Osteoporosis International, 8, 399-403. http://dx.doi.org/10.1007/s001980050082
- Christensen, J.O. and Svendsen, O.L. (1999) Bone Mineral in Pre- and Postmenopausal Women with Insulin-Dependent and Non-Insulin-Dependent Diabetes Mellitus. Osteoporosis International, 10, 307-311. http://dx.doi.org/10.1007/s001980050232