{"title":"利用高分辨率外周定量计算机断层扫描成像研究糖尿病周围神经病变的骨小梁和皮质骨微结构","authors":"Durairaj Arjunan, Ashu Rastogi, Jayaditya Ghosh, Soham Mukherjee, Raveena Singh, Vandana Dhiman, Sanjay K. Bhadada","doi":"10.1016/j.dsx.2024.103109","DOIUrl":null,"url":null,"abstract":"<div><h3>Context</h3><p>Type 2 Diabetes Mellitus (T2D) is associated with an increased risk of fragility fracture despite normal areal bone mineral density (BMD). The contribution of diabetic peripheral neuropathy (PN) to volumetric BMD (vBMD) and bone microarchitecture in T2D is not explored.</p></div><div><h3>Objective</h3><p>To assess vBMD and microarchitectural properties of bone using high-resolution peripheral quantitative computed tomography (HR-pQCT) in patients of T2D with or without PN.</p></div><div><h3>Design</h3><p>This is a cross-sectional study of patients of T2D divided into two groups [patients with T2D without PN (Group A) and T2D with PN (Group B)]. All patients underwent clinical examination, biochemical evaluation, dual-energy X-ray absorptiometry (DXA), and HR-pQCT of the radius and tibia.</p></div><div><h3>Results</h3><p>A total of 296 patients were included in the study [Group A (n = 98), Group B (n = 198)]. HR-pQCT demonstrated a significant difference in total vBMD[mg/cm<sup>3</sup>] at tibia (291.6 ± 61.8 vs. 268.2 ± 63.0; p-0.003); cortical vBMD[mg/cm<sup>3</sup>] at tibia [912.5 (863.3, 962.4) vs. 853.8 (795.3, 913.2) p-0.000], among groups A and B respectively. Among the microarchitecture parameters, there was a significant difference in cortical porosity at the tibia (2.5% ±1.7% vs. 3%±1.7%; p-0.004), trabecular number[mm<sup>-1</sup>] at the tibia [1.080 (0.896, 1.237) vs. 1.140 (0.983, 1.286), p-0.045] and trabecular thickness[mm] at the radius [0.228 (0.217, 0.247) Vs. 0.238 (0.224, 0.253); p-0.006], among groups A and B respectively.</p></div><div><h3>Conclusion</h3><p>Despite comparable areal BMD, T2D patients with PN have diminished vBMD and deteriorated skeletal microarchitecture, compared to those without PN.</p></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 8","pages":"Article 103109"},"PeriodicalIF":4.3000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Trabecular and cortical bone microarchitecture using high-resolution peripheral quantitative computed tomographic imaging in diabetic peripheral neuropathy\",\"authors\":\"Durairaj Arjunan, Ashu Rastogi, Jayaditya Ghosh, Soham Mukherjee, Raveena Singh, Vandana Dhiman, Sanjay K. Bhadada\",\"doi\":\"10.1016/j.dsx.2024.103109\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Context</h3><p>Type 2 Diabetes Mellitus (T2D) is associated with an increased risk of fragility fracture despite normal areal bone mineral density (BMD). The contribution of diabetic peripheral neuropathy (PN) to volumetric BMD (vBMD) and bone microarchitecture in T2D is not explored.</p></div><div><h3>Objective</h3><p>To assess vBMD and microarchitectural properties of bone using high-resolution peripheral quantitative computed tomography (HR-pQCT) in patients of T2D with or without PN.</p></div><div><h3>Design</h3><p>This is a cross-sectional study of patients of T2D divided into two groups [patients with T2D without PN (Group A) and T2D with PN (Group B)]. All patients underwent clinical examination, biochemical evaluation, dual-energy X-ray absorptiometry (DXA), and HR-pQCT of the radius and tibia.</p></div><div><h3>Results</h3><p>A total of 296 patients were included in the study [Group A (n = 98), Group B (n = 198)]. HR-pQCT demonstrated a significant difference in total vBMD[mg/cm<sup>3</sup>] at tibia (291.6 ± 61.8 vs. 268.2 ± 63.0; p-0.003); cortical vBMD[mg/cm<sup>3</sup>] at tibia [912.5 (863.3, 962.4) vs. 853.8 (795.3, 913.2) p-0.000], among groups A and B respectively. Among the microarchitecture parameters, there was a significant difference in cortical porosity at the tibia (2.5% ±1.7% vs. 3%±1.7%; p-0.004), trabecular number[mm<sup>-1</sup>] at the tibia [1.080 (0.896, 1.237) vs. 1.140 (0.983, 1.286), p-0.045] and trabecular thickness[mm] at the radius [0.228 (0.217, 0.247) Vs. 0.238 (0.224, 0.253); p-0.006], among groups A and B respectively.</p></div><div><h3>Conclusion</h3><p>Despite comparable areal BMD, T2D patients with PN have diminished vBMD and deteriorated skeletal microarchitecture, compared to those without PN.</p></div>\",\"PeriodicalId\":48252,\"journal\":{\"name\":\"Diabetes & Metabolic Syndrome-Clinical Research & Reviews\",\"volume\":\"18 8\",\"pages\":\"Article 103109\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetes & Metabolic Syndrome-Clinical Research & Reviews\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S187140212400170X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S187140212400170X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
摘要
背景2型糖尿病(T2D)与脆性骨折风险增加有关,尽管其总体骨矿物质密度(BMD)正常。目的使用高分辨率外周定量计算机断层扫描(HR-pQCT)评估有无 PN 的 T2D 患者的体积骨密度(vBMD)和骨微结构特性。所有患者均接受了临床检查、生化评估、双能 X 射线吸收测定(DXA)以及桡骨和胫骨的 HR-pQCT 检查。HR-pQCT显示,A组和B组胫骨总vBMD[mg/cm3] (291.6 ± 61.8 vs. 268.2 ± 63.0; p-0.003)、胫骨皮质vBMD[mg/cm3] (912.5 (863.3, 962.4) vs. 853.8 (795.3, 913.2) p-0.000)分别存在显著差异。在微结构参数中,胫骨皮质孔隙率(2.5%±1.7% vs. 3%±1.7%; p-0.004)、胫骨小梁数[mm-1] [1.080 (0.896, 1.237) vs. 1.140 (0.983, 1.286), p-0.045]和桡骨小梁厚度[mm] [0.结论与无 PN 的 T2D 患者相比,尽管总 BMD 相当,但有 PN 的 T2D 患者 vBMD 减少,骨骼微结构恶化。
Trabecular and cortical bone microarchitecture using high-resolution peripheral quantitative computed tomographic imaging in diabetic peripheral neuropathy
Context
Type 2 Diabetes Mellitus (T2D) is associated with an increased risk of fragility fracture despite normal areal bone mineral density (BMD). The contribution of diabetic peripheral neuropathy (PN) to volumetric BMD (vBMD) and bone microarchitecture in T2D is not explored.
Objective
To assess vBMD and microarchitectural properties of bone using high-resolution peripheral quantitative computed tomography (HR-pQCT) in patients of T2D with or without PN.
Design
This is a cross-sectional study of patients of T2D divided into two groups [patients with T2D without PN (Group A) and T2D with PN (Group B)]. All patients underwent clinical examination, biochemical evaluation, dual-energy X-ray absorptiometry (DXA), and HR-pQCT of the radius and tibia.
Results
A total of 296 patients were included in the study [Group A (n = 98), Group B (n = 198)]. HR-pQCT demonstrated a significant difference in total vBMD[mg/cm3] at tibia (291.6 ± 61.8 vs. 268.2 ± 63.0; p-0.003); cortical vBMD[mg/cm3] at tibia [912.5 (863.3, 962.4) vs. 853.8 (795.3, 913.2) p-0.000], among groups A and B respectively. Among the microarchitecture parameters, there was a significant difference in cortical porosity at the tibia (2.5% ±1.7% vs. 3%±1.7%; p-0.004), trabecular number[mm-1] at the tibia [1.080 (0.896, 1.237) vs. 1.140 (0.983, 1.286), p-0.045] and trabecular thickness[mm] at the radius [0.228 (0.217, 0.247) Vs. 0.238 (0.224, 0.253); p-0.006], among groups A and B respectively.
Conclusion
Despite comparable areal BMD, T2D patients with PN have diminished vBMD and deteriorated skeletal microarchitecture, compared to those without PN.
期刊介绍:
Diabetes and Metabolic Syndrome: Clinical Research and Reviews is the official journal of DiabetesIndia. It aims to provide a global platform for healthcare professionals, diabetes educators, and other stakeholders to submit their research on diabetes care.
Types of Publications:
Diabetes and Metabolic Syndrome: Clinical Research and Reviews publishes peer-reviewed original articles, reviews, short communications, case reports, letters to the Editor, and expert comments. Reviews and mini-reviews are particularly welcomed for areas within endocrinology undergoing rapid changes.