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 1 型糖尿病 (T1D) 患者发生髋部骨折的风险比普通人高六到八倍 没有糖尿病的情况下，髋部骨折与显着的发病率、死亡率、独立性丧失和 此外，与受试者相比，糖尿病患者的髋部骨折死亡率更高。 没有糖尿病。 双 X 射线吸收测定法 (DXA) 是评估骨骼健康的最常见测试，但会低估骨折风险 年轻发病的 T1D 患者（20 岁之前诊断为 T1D）几何形状发生改变，骨质减少。 机械和材料质量与 1 型糖尿病患者的骨脆性有关。 假定抑制骨转换，导致微损伤和晚期糖化的积累 尽管骨折风险较高，但最终产物（AGE）导致 T1D 骨材料特性受损。 T1D 对骨结构和材料特性的影响以及影响骨健康的糖尿病相关因素 未知。 考虑到知识差距，我们建议使用经过验证的骨骼表型来评估基线骨骼表型 定量计算机断层扫描 (QCT)、基于有限元 (FE) 的骨强度和 OsteoProbe®- 测量体内骨材料强度指数 (BMSi)，以及这些指标在 3 年内的大变化 正在进行的“1 型糖尿病中的冠状动脉钙化”研究中患有和未患有 T1D 的成年人队列 （CACTI）研究，我们还将确定急性高血糖和低血糖对骨转换及其作用的影响。 对骨材料特性的长期影响。 随着护理的改善，T1D 患者的寿命更长，并且没有具体的预防和治疗方法 因此，该研究项目将有助于表征老年 T1D 的骨质疏松症。 骨表型以及三年内长期高血糖对骨变化的影响； 因此，未来的临床试验将有助于改善成人骨骼健康并降低骨折风险 T1D。