Profiling bone status indices reveals evidence of a low-turnover bone phenotype in type 2 diabetes: findings from the DiaFALL cohort
Abstract
UNLABELLED: People with type 2 diabetes have increased fracture risk despite preserved bone density. In this matched cross-sectional study, suppressed Bone Status Indices and exploratory sex-related hormonal associations were observed in T2D, indicating altered bone remodeling that is not captured by aBMD alone. These findings support the need for fracture risk assessment approaches that incorporate biochemical markers and potential sex-related differences.
INTRODUCTION/AIM: People with type 2 diabetes (T2D) experience increased fracture risk despite preserved or higher areal bone mineral density (aBMD). We evaluated Bone Status Indices (BSIs) and their relationships with aBMD in T2D, with exploratory evaluation of sex-related hormonal influences.
METHODS: In this matched cross-sectional study from the DiaFALL cohort, 105 adults with T2D were compared 1:1 with age- and sex-matched controls. aBMD was assessed at lumbar spine, femoral neck, arms, and legs using DXA. BSIs included intact PINP (i-PINP), β-CTX-I, osteocalcin (OCN), sclerostin, TRACP5b, IGF-1, OPN, PTH, and vitamin-D metabolites. Group differences and associations with aBMD were evaluated using multivariable regression and Spearman correlations, with exploratory sex-stratified analyses.
RESULTS: Femoral-neck aBMD was higher in people with T2D (men: + 0.070 g/cm2, 95%CI + 0.026 to + 0.114, p = 0.002; women: + 0.089, 95%CI + 0.039 to + 0.139, p = 0.001) and lumbar-spine aBMD was higher in women (+ 0.137 g/cm2, 95%CI…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 105 participants or records.
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