Does Bone Structure Explain the Increased Fracture Risk in Type II Diabetes Patients? A Pilot Study
Condition: Osteoporosis
MeSH terms: Osteoporosis; Diabetes Mellitus, Type 2
Study type: Observational

Summary: 
      For this cross-sectional case control pilot study 30 women, 55-75 years old with type II
      diabetes will be recruited. Diabetes will be defined as self-report of diabetes previously
      diagnosed by a physician, use of hypoglycemic medications, or fasting glucose > 126 mg/dl
      (7.0mM) in accordance with the American Diabetes Association criteria. The diabetic patient
      population will be divided into 2 groups: patients with status post low energy fractures of
      the proximal humerus, the proximal femur, the ankle and the foot (n=10) versus diabetic
      patients with no fractures or low energy trauma fracture history (n=10). An additional group
      of 10 diabetic postmenopausal women will be recruited and will have magnetic resonance
      imaging (MRI) of the lower back only. Caucasian, Asian and Hispanic women will be combined
      since a previous study suggested that BMD is very similar in these 3 population and that
      ethnic differences are minimal. In addition a population of 10 age-matched, BMI-matched,
      race-matched healthy women, without osteoporotic fractures will be examined. In all of these
      volunteers a medical history will be obtained to ensure good health status and rule out
      chronic diseases that would have an impact on bone metabolism. Patients will undergo MRI, QCT
      and high-resolution peripheral quantitative computed tomography (HR-pQCT) examinations to
      determine bone mineral density and bone structure/quality.

      The hypothesis of this pilot project is that type II diabetic patients with and without
      low-energy fractures have a different trabecular bone architecture and composition, which is
      also different when compared to normal age-matched healthy patients. Architectural
      differences in these three patient groups may be visualized with high resolution MRI and
      high-resolution peripheral quantitative computed tomography (HR-pQCT) and will be most
      pronounced at the calcaneus and the distal tibia. Analyzing structure parameters obtained
      from high resolution MRI and spectroscopy may improve our understanding of the
      pathophysiology of diabetic bone disease and the prediction of fracture risk in an elderly
      diabetic population.
    


Intervention name(s): magnetic Resonance Imaging; Computed Tomography; High resolution peripheral quantitative computed tomography
Intervention type(s): Device; Device; Device
Intervention description(s): MRI of the calcaneus, the distal tibia, the distal radius and also lower back.; CT scan of the lower back and hip; HR-pQCT of the distal radius and distal tibia
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        10 healthy postmenopausal women 10 postmenopausal women with Type II Diabetes and without
        fracture 10 postmenopausal women with Type II Diabetes and with fracture of the long bone
        of the upper arm, hip, ankle, or foot 10 postmenopausal women with Type II Diabetes with
        and without fracture
      
Keywords: osteoporosis; diabetes