Endocrine Abstracts

Research object: Since type 1 diabetic (T1D) patients are at higher fracture risk in comparison to general population the aim of study was to assess, whether femur geometric parameters are connected with Fx in T1D females.

Materials and methods: We examined 68 T1D 31 yrs. old (25–37.6) females with disease duration of 11 (7–17) yrs. and the average HbA1c equal to 8.5 (6.9–10.4) %. The control group consisted of 53 healthy age- and BMI-matched females. Bone mineral density (BMD) and VFx were measured with dual X-ray absorptiometry. Geometric parameters were determined using Advanced Hip Analysis program.

Results: T1D females had lower BMD at femoral neck (T1D: Z-score −0.5((−1.1)−0.2) vs controls: Z-score 0.1 ((−0.6)−0.7), P=0.006, respectively), higher frequency of fragility Fx (T1D: n=10 vs controls: n=2, P=0.042, respectively), VFx (T1D: n=12 vs controls: n=1, P<0.01, respectively) compared to controls. Differences in the hip geometric parameter of CSA in women did not reach a statistically significant difference, however, there was a tendency to decrease this parameter in the group of T1D women. Age, diabetes duration, age of diabetes manifestation, and the prevalence of chronic complications were not different between type 1 diabetics with and without VFx. When comparing patients with VFx and without it it was found that in patients with type 1 diabetes with a VFx the BMD (Z-score) is lower both at spine (−1.7((−2.3)–(−1.0)) vs −0.3((−1.1)−0.5), P<0.001, respectively) and at femoral neck (−1.4±1.1 vs −0.5±1.05, P=0.002, respectively) and the daily insulin dose per kg is higher (0.89(0.76–1.25) vs. 0.69(0.54–0.9), P=0,010 respectively). T1D females with VFx had lower CSMI (cross-sectional moment of inertia) (T1D with VFx: 7836 (6533–10377) vs. T1D without VFx 10140(8770–12522), P=0.035, respectively) and CSA (cross-sectional area) (T1D with VFx: 122(104–137) vs. T1D without VFx 144(129–165) P=0.006, respectively) compared with T1D females without VFx. In the logit regression analysis VFx were associated with BMD spine, CSA and daily insulin dose.

Conclusions: Type 1 diabetic women have low BMD, higher prevalence of VFx. VFx were associated with BMD spine, CSA and daily insulin dose.