A 10-Year Prospective Study of Bone Mineral Density and Bone Turnover in Males and Females with Type 1 Diabetes

Emma J. Hamilton, Jocelyn J. Drinkwater, S. A. Paul Chubb, Valentina Rakic, Niklaus Kamber, Kun Zhu, Richard L. Prince, Wendy A. Davis, Timothy M.E. Davis

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Abstract

Context: In a previous community-based, cross-sectional study, males with type 1 diabetes (T1D) had lower bone mineral density (BMD) than did matched people without diabetes but females with T1D had normal BMD. Objective: To determine whether BMD in the males continued to decline, the neutral effect of T1D on BMD in females persisted, and whether temporal BMD changes reflected changes in bone turnover markers. Design: Longitudinal observational study. Setting: Urban community. Patients: Forty-eight of the original 102 original cross-sectional study participants (20 males, 28 females) of mean age 42.0 years and median diabetes duration 14.6 years at baseline who were restudied a mean of 10.3 years later. Main Outcome Measures: BMD at total hip, femoral neck, lumbar spine (L1 to L4), and distal forearm. Biochemical bone turnover markers. Results: After adjustment for age, body mass index (BMI), and renal function, there was no temporal change in BMD at the hip or forearm in the males (P ≥ 0.12), but lumbar spine BMD increased (P = 0.009). Females exhibited no statistically significant change in BMD in similar multivariable models that also included postmenopausal status, except a mild increase at the forearm (P = 0.046). Age- and sex-related changes in bone turnover markers paralleled those in general population studies. Conclusions: There is a reduction in BMD in males with T1D that occurs early in the course of the disease but then stabilizes. BMD in females with T1D remains similar to that expected for age, BMI, and postmenopausal status.

Original languageEnglish
Pages (from-to)3531-3539
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume103
Issue number9
DOIs
Publication statusPublished - 1 Sep 2018

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Bone Remodeling
Medical problems
Type 1 Diabetes Mellitus
Bone Density
Minerals
Bone
Prospective Studies
Bone and Bones
Forearm
Hip
Spine
Body Mass Index
Cross-Sectional Studies
Temporal Bone
Femur Neck
Observational Studies
Longitudinal Studies
Outcome Assessment (Health Care)
Kidney

Cite this

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title = "A 10-Year Prospective Study of Bone Mineral Density and Bone Turnover in Males and Females with Type 1 Diabetes",
abstract = "Context: In a previous community-based, cross-sectional study, males with type 1 diabetes (T1D) had lower bone mineral density (BMD) than did matched people without diabetes but females with T1D had normal BMD. Objective: To determine whether BMD in the males continued to decline, the neutral effect of T1D on BMD in females persisted, and whether temporal BMD changes reflected changes in bone turnover markers. Design: Longitudinal observational study. Setting: Urban community. Patients: Forty-eight of the original 102 original cross-sectional study participants (20 males, 28 females) of mean age 42.0 years and median diabetes duration 14.6 years at baseline who were restudied a mean of 10.3 years later. Main Outcome Measures: BMD at total hip, femoral neck, lumbar spine (L1 to L4), and distal forearm. Biochemical bone turnover markers. Results: After adjustment for age, body mass index (BMI), and renal function, there was no temporal change in BMD at the hip or forearm in the males (P ≥ 0.12), but lumbar spine BMD increased (P = 0.009). Females exhibited no statistically significant change in BMD in similar multivariable models that also included postmenopausal status, except a mild increase at the forearm (P = 0.046). Age- and sex-related changes in bone turnover markers paralleled those in general population studies. Conclusions: There is a reduction in BMD in males with T1D that occurs early in the course of the disease but then stabilizes. BMD in females with T1D remains similar to that expected for age, BMI, and postmenopausal status.",
author = "Hamilton, {Emma J.} and Drinkwater, {Jocelyn J.} and {Paul Chubb}, {S. A.} and Valentina Rakic and Niklaus Kamber and Kun Zhu and Prince, {Richard L.} and Davis, {Wendy A.} and Davis, {Timothy M.E.}",
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A 10-Year Prospective Study of Bone Mineral Density and Bone Turnover in Males and Females with Type 1 Diabetes. / Hamilton, Emma J.; Drinkwater, Jocelyn J.; Paul Chubb, S. A.; Rakic, Valentina; Kamber, Niklaus; Zhu, Kun; Prince, Richard L.; Davis, Wendy A.; Davis, Timothy M.E.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 103, No. 9, 01.09.2018, p. 3531-3539.

Research output: Contribution to journalArticle

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T1 - A 10-Year Prospective Study of Bone Mineral Density and Bone Turnover in Males and Females with Type 1 Diabetes

AU - Hamilton, Emma J.

AU - Drinkwater, Jocelyn J.

AU - Paul Chubb, S. A.

AU - Rakic, Valentina

AU - Kamber, Niklaus

AU - Zhu, Kun

AU - Prince, Richard L.

AU - Davis, Wendy A.

AU - Davis, Timothy M.E.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Context: In a previous community-based, cross-sectional study, males with type 1 diabetes (T1D) had lower bone mineral density (BMD) than did matched people without diabetes but females with T1D had normal BMD. Objective: To determine whether BMD in the males continued to decline, the neutral effect of T1D on BMD in females persisted, and whether temporal BMD changes reflected changes in bone turnover markers. Design: Longitudinal observational study. Setting: Urban community. Patients: Forty-eight of the original 102 original cross-sectional study participants (20 males, 28 females) of mean age 42.0 years and median diabetes duration 14.6 years at baseline who were restudied a mean of 10.3 years later. Main Outcome Measures: BMD at total hip, femoral neck, lumbar spine (L1 to L4), and distal forearm. Biochemical bone turnover markers. Results: After adjustment for age, body mass index (BMI), and renal function, there was no temporal change in BMD at the hip or forearm in the males (P ≥ 0.12), but lumbar spine BMD increased (P = 0.009). Females exhibited no statistically significant change in BMD in similar multivariable models that also included postmenopausal status, except a mild increase at the forearm (P = 0.046). Age- and sex-related changes in bone turnover markers paralleled those in general population studies. Conclusions: There is a reduction in BMD in males with T1D that occurs early in the course of the disease but then stabilizes. BMD in females with T1D remains similar to that expected for age, BMI, and postmenopausal status.

AB - Context: In a previous community-based, cross-sectional study, males with type 1 diabetes (T1D) had lower bone mineral density (BMD) than did matched people without diabetes but females with T1D had normal BMD. Objective: To determine whether BMD in the males continued to decline, the neutral effect of T1D on BMD in females persisted, and whether temporal BMD changes reflected changes in bone turnover markers. Design: Longitudinal observational study. Setting: Urban community. Patients: Forty-eight of the original 102 original cross-sectional study participants (20 males, 28 females) of mean age 42.0 years and median diabetes duration 14.6 years at baseline who were restudied a mean of 10.3 years later. Main Outcome Measures: BMD at total hip, femoral neck, lumbar spine (L1 to L4), and distal forearm. Biochemical bone turnover markers. Results: After adjustment for age, body mass index (BMI), and renal function, there was no temporal change in BMD at the hip or forearm in the males (P ≥ 0.12), but lumbar spine BMD increased (P = 0.009). Females exhibited no statistically significant change in BMD in similar multivariable models that also included postmenopausal status, except a mild increase at the forearm (P = 0.046). Age- and sex-related changes in bone turnover markers paralleled those in general population studies. Conclusions: There is a reduction in BMD in males with T1D that occurs early in the course of the disease but then stabilizes. BMD in females with T1D remains similar to that expected for age, BMI, and postmenopausal status.

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DO - 10.1210/jc.2018-00850

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