Endocrine Abstracts

Introduction: Osteoporosis is a well known long-term complication after simultaneous pancreas kidney transplantation (SPK). Alterations of bone microstructure contribute to the risk of fracture and trabecular bone score (TBS) measurement offers and additional tool to quantify bone microarchitecture impairment.

Methods: There were 33 subjects with type 1 diabetes mellitus (23 men, 10 women, mean age 43.4 ± 9.8 years) participating in a prospective observational study with areal bone mineral density (aBMD) of lumbar spine (LS) and femoral neck (FN) and lumbar TBS evaluation in years 0, 1 and 3 after the successful SPK. Apparatus Lunar Prodigy Primo with TBS insight software version 3.0.3.0 was used for the data retrievement.

Results: Mean creatinine, HbA1c (IFCC) andPTH concentrations 3 years after SPK were as follows: 136.7 ± 68.9 umol/l; 38.8 ± 6.9 mmol/mol and 11.7 ± 8.1 pmol/l. LSaBMD wasinitially in osteopenic range but increased significantlyduring the whole follow-up (Z-score: −1.12 ± 1.31 vs −0.14 ± 1.25; P < 0.001), FN aBMD remained diminished with only insignificant increase (Z score: −1.42 ± 0.92 vs −1.19 ± 0.83; NS). Mean TBS was low (1.201 ± 0.118) and high-risk value ( < 1.23) was initially registered in 18 subjects (54%). Maximal TBS increment was documented during the first post-transplant year (1.201 ± 0.118 vs 1.292 ± 0,108; P < 0.01) with later stabilization (1.292 ± 0.108 vs 1.272 ± 0.115; NS).

Conclusions: Subjects after SPK are at risk of low aBMD especially at cortical sites. Bone microstructure is significantly affected as documented by low TBS and diminished valuespersist despite its improvement during the first post--transplant year. Further investigation to identify risk factors connected with low TBS values and its role in fracture prediction in post-transplant period is needed.