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Research article
Mercè Giner
Universidad de Sevilla: Universidad de Sevilla
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8285-0767
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Type 2 Diabetes Mellitus (T2DM) is one of the most common chronic diseases worldwide and it is associated with an increased risk of osteoporosis and fragility fractures. Our purpose was to analyse microstructural and bone mechanics from femoral heads, markers of bone turnover and bone mineral density in T2DM patients with or without recent fragility fractures. To identify the factors that influence this risk and elucidate diabetes-induced alterations in trabecular bone microarchitecture and bone turnover markers.
Methods: The studied population consisted of 28 patients, divided in 4 groups: 6 subjects with hip fracture (OP) without T2DM, 8 patients with hip fracture and T2DM (OP-T2DM), 7 patients with osteoarthritis (OA) without T2DM and 7 patients OA and with T2DM (OA-T2DM). Bone markers, bone mineral density, FRAX score, microstructural and bone material strength from femoral heads and were assessed.
Results: The group with hip fracture presented lower BMD values than OA (p <0.05). The OP, OP-T2DM and OA-T2DM groups showed a decrease in bone volume fraction (BV/TV); trabecular number (Tb.N); trabecular thickness (Tb.Th) and increase of the structural model index (SMI) and trabecular bone pattern factor (Tb.Pf), as microstructure results and Young's modulus or elastic modulus; toughness; ultimate stress; ultimate load; extrinsic stiffness and work to failure, as biomechanical results, regarding OA patients (p <0.05).
Conclusion: Our results show the negative effect of Type 2 Diabetes Mellitus on trabecular bone structure and mechanical properties. These results emphasize the importance of evaluating diabetic bones using not only bone markers and bone mass, but also bone quality parameters. Therefore, diabetes should be included as a risk factor for osteoporotic fracture in daily clinical practice and in the FRAX tool.
Keywords
Trauma, Fracture, Hip, Diagnostic, Imaging, Osteoporosis, Type 2 Diabetes Mellitus
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CURRENT STATUS: Under Review
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Posted 23 Nov, 2020
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Editorial decision: Major revision
On 21 Jan, 2021
Review #2 received
Received 12 Jan, 2021
Reviewer #2 agreed
On 22 Dec, 2020
Review #1 received
Received 05 Dec, 2020
Reviewer #1 agreed
On 28 Nov, 2020
Reviewers invited
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Orthopedics
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A new preprint design is coming!
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This preprint is under consideration at BMC Musculoskeletal Disorders. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Mercè Giner
Universidad de Sevilla: Universidad de Sevilla
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8285-0767
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 23 Nov, 2020
No community comments so far
Editorial decision: Major revision
On 21 Jan, 2021
Review #2 received
Received 12 Jan, 2021
Reviewer #2 agreed
On 22 Dec, 2020
Review #1 received
Received 05 Dec, 2020
Reviewer #1 agreed
On 28 Nov, 2020
Reviewers invited
Invitations sent on 26 Nov, 2020
Editor assigned
On 18 Oct, 2020
Submission checks complete
On 17 Oct, 2020
Editor invited
On 17 Oct, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Type 2 Diabetes Mellitus (T2DM) is one of the most common chronic diseases worldwide and it is associated with an increased risk of osteoporosis and fragility fractures. Our purpose was to analyse microstructural and bone mechanics from femoral heads, markers of bone turnover and bone mineral density in T2DM patients with or without recent fragility fractures. To identify the factors that influence this risk and elucidate diabetes-induced alterations in trabecular bone microarchitecture and bone turnover markers.
Methods: The studied population consisted of 28 patients, divided in 4 groups: 6 subjects with hip fracture (OP) without T2DM, 8 patients with hip fracture and T2DM (OP-T2DM), 7 patients with osteoarthritis (OA) without T2DM and 7 patients OA and with T2DM (OA-T2DM). Bone markers, bone mineral density, FRAX score, microstructural and bone material strength from femoral heads and were assessed.
Results: The group with hip fracture presented lower BMD values than OA (p <0.05). The OP, OP-T2DM and OA-T2DM groups showed a decrease in bone volume fraction (BV/TV); trabecular number (Tb.N); trabecular thickness (Tb.Th) and increase of the structural model index (SMI) and trabecular bone pattern factor (Tb.Pf), as microstructure results and Young's modulus or elastic modulus; toughness; ultimate stress; ultimate load; extrinsic stiffness and work to failure, as biomechanical results, regarding OA patients (p <0.05).
Conclusion: Our results show the negative effect of Type 2 Diabetes Mellitus on trabecular bone structure and mechanical properties. These results emphasize the importance of evaluating diabetic bones using not only bone markers and bone mass, but also bone quality parameters. Therefore, diabetes should be included as a risk factor for osteoporotic fracture in daily clinical practice and in the FRAX tool.
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