Relation between the insulin lowering rate and changes in bone mineral density: Analysis among subtypes of type 1 diabetes mellitus.

Abstract

AIMS/INTRODUCTION:

The bone mineral density in patients with type 1 diabetes mellitus is reduced due to impaired insulin secretion. However, it is unclear whether the rate of bone mineral density reduction is affected by the type 1 diabetes mellitus subtype. This study aimed to clarify the difference in bone mineral density across type 1 diabetes mellitus subtypes: slowly progressive (SP), acute-onset (AO), and fulminant (F).

METHODS:

This was a retrospective, single-center, cross-sectional study conducted on 98 adult type 1 diabetes mellitus patients. The main outcome included the bone mineral density Z-score (BMD-Z) measured at the lumbar spine and femoral neck.

RESULTS:

The lumbar spine BMD-Z was lower in the acute-onset than in the slowly progressive subtype (P = 0.03). No differences were observed when compared with the fulminant subtype. The femoral neck BMD-Z tended to be higher in the slowly progressive than in the acute-onset and fulminant subtypes. Multiple regression analyses showed that the lumbar spine BMD-Z was associated with subtypes (AO vs SP) (P = 0.01), but not subtypes (F vs SP), adjusted for sex, duration, retinopathy, and C-peptide immunoreactivity (CPR). When the patients were divided into disease duration tertiles, in the first and second tertiles, the CPR levels were lower in the acute-onset or fulminant than in the slowly progressive subtype. In contrast, the lumbar spine and femoral neck BMD-Z differed between the acute-onset and slowly progressive only in the second tertiles (both P < 0.01), with a similar tendency between the fulminant and slowly progressive subtypes.

CONCLUSIONS:

Among the type 1 diabetes mellitus subtypes, bone mineral density undergoes time-dependent changes, which reveals that the bone mineral density decline follows the impaired insulin secretion. These results provide novel insights into the association between the low insulin exposure duration and bone mineral density.

• Authors: Masaki Suzuki, Shin Urai, Hidenori Fukuoka, Yushi Hirota, Masaaki Yamamoto, Yuko Okada, Naoki Yamamoto, Hiroki Shichi, Yasunori Fujita, Keitaro Kanie, Genzo Iguchi, Yutaka Takahashi, Wataru Ogawa
• Journal: Journal of diabetes investigation (J Diabetes Investig) Vol. 13 Issue 9 Pg. 1585-1595 (Sep 2022) ISSN: 2040-1124 [Electronic] Japan
• PMID: 35470583 (Publication Type: Journal Article)
• Copyright: © 2022 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

Chemical References

• Insulin

Topics

• Adult
• Bone Density
• Cross-Sectional Studies
• Diabetes Mellitus, Type 1 (chemically induced, complications, drug therapy)
• Humans
• Insulin (adverse effects)
• Lumbar Vertebrae (diagnostic imaging)
• Retrospective Studies