Bone Health in Adults with Type 1 Diabetes

成人 1 型糖尿病患者的骨骼健康

• 批准号: 10228685
• 负责人: Viral N Shah
• 金额: $ 36.55万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-13 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10228685
• 关键词: 20 year old; Acute; Address; Adult; Advanced Glycosylation End Products; Affect; Age; Area; Body mass index; Bone Density; Bone Resorption; Bone Tissue; Bone structure; Caring; Chronic; Clinical Trials; Closure by clamp; Diabetes Mellitus; Diagnosis; Elderly; Elements; Femur; Financial Hardship; Future; Gender; Geometry; Hip Fractures; Hip region structure; Hyperglycemia; Hypoglycemia; Impairment; Insulin; Insulin-Dependent Diabetes Mellitus; Intervention; Intervention Trial; Knowledge; Long-Term Effects; Measures; Mechanics; Morbidity - disease rate; Osteoporosis; Patients; Phenotype; Population; Prevention approach; Property; Prospective cohort study; Research; Research Project Grants; Risk; Roentgen Rays; Role; Testing; Thick; Time; Vertebral column; Work; X-Ray Computed Tomography; base; bone; bone fragility; bone health; bone mass; bone quality; bone strength; bone turnover; cohort; coronary artery calcification; epidemiology study; fracture risk; glycemic control; high risk; improved; in vivo; indexing; insulin dependent diabetes mellitus onset; mortality; non-diabetic; risk prediction model; skeletal; tibia

Abstract People with type 1 diabetes (T1D) have a six- to eight-fold higher risk for hip fractures compared to people without diabetes. Hip fractures are associated with significant morbidity, mortality, loss of independence, and financial burden. Moreover, hip fracture mortality is higher in patients with diabetes compared to subjects without diabetes. Dual x-ray absorptiometry (DXA), the most common test to assess bone health, underestimates fracture risk in patients with T1D. Altered geometry in young-onset T1D (T1D diagnosis before age 20), and reduced bone mechanical and material qualities are implicated in bone fragility in T1D. Chronic hyper- and hypoglycemia is postulated to suppress bone turnover leading to accumulation of microdamage and advanced glycation endproducts (AGE) resulting in compromised bone material properties in T1D. Despite higher fracture risk, the effect of T1D on bone structural and material properties and diabetes-related factors affecting bone health are unknown. Considering the knowledge gap, we propose to evaluate baseline skeletal phenotype using validated quantitative computed tomography (QCT), finite element (FE) based bone strength, and OsteoProbe®- measured in vivo bone material strength index (BMSi), and changes in these measures over 3 years in a large cohort of adults with and without T1D from the ongoing ‘Coronary Artery Calcification in Type 1 Diabetes’ (CACTI) study. We will also determine the role of acute hyper- and hypoglycemia on bone turnover and its long-term impact on bone material properties. With improved care, people with T1D are living longer and there is no specific approach for prevention and treatment of osteoporosis for older adults with T1D. Therefore, this research project will help to characterize bone phenotype and the effect of long-term hyperglycemia on bone changes over a period of three years; and therefore, it will allow for future clinical trials to improve bone health and reduce facture risk among adults with T1D.

抽象的 与人相比 没有糖尿病。髋部骨折与明显的发病率，死亡率，独立丧失以及 财务负担。此外，糖尿病患者与受试者相比，髋部骨折死亡率更高 没有糖尿病。 双X射线绝对肽仪（DXA）是评估骨骼健康的最常见测试，低估了骨折风险 T1D患者。年轻T1D的几何形状改变（20岁之前的T1D诊断），骨骼减少 T1D中的骨骼脆弱性暗示了机械和材料质量。慢性高血糖症是 假定是为了抑制骨转换，导致微塑料和晚期糖基的积累 最终产物（年龄）导致T1D中的骨骼材料特性受损。尽管骨折风险更高，但 T1D对影响骨骼健康的骨结构和材料特性以及与糖尿病有关的因素的影响是 未知。 考虑到知识差距，我们建议使用经过验证的基线骨骼表型评估基线骨骼表型 定量计算机断层扫描（QCT），有限元（Fe）骨强度和Osteopobe®- 在体内骨材料强度指数（BMSI）中测量，并在3年​​内进行这些测量的变化 来自有或没有T1D的成年人的队列来自正在进行的“ 1型糖尿病中的冠状动脉钙化” （仙人掌）研究。我们还将确定急性高血糖和低血糖对骨转换及其的作用 长期对骨骼材料特性的影响。 随着护理的改善，患有T1D的人的寿命更长，没有特定的预防方法和 治疗T1D老年人的骨质疏松症。因此，该研究项目将有助于表征 骨表型和长期高血糖对骨骼变化的影响在三年内；和 因此，这将允许将来的临床试验改善骨骼健康，并降低 T1D。