Trabecular Bone Score Is Lower in Adults with Type 1 Diabetes and Is Related to Visceral and Pericardial Fat but Not Body Mass Index or Subcutaneous Fat

Presentation Number: MON 354
Date of Presentation: April 3rd, 2017

Viral Shah*1, Laura Pyle2, Prakriti Joshee2, Danielle Ostendorf3, Wendy M Kohrt4, Amy Alman5 and Janet K Snell-Bergeon2
1University of Colorado, Aurora, CO, 2Barbara Davis Center for Diabetes, Aurora, CO, 3Colorado School of Public Health, Aurora, CO, 4University of Colorado, Anschutz Medical Campus, Aurora, CO, 5University of South Florida, Tampa, FL


Studies have shown a higher fracture risk in type 1 diabetes (T1D) than in non-diabetic individuals (1) that cannot be explained by bone mineral density (BMD) alone. Similarly, cardiovascular disease (CVD) risk is increased in adults with T1D, but the increase in risk is not fully explained by traditional CVD risk factors (2). This pilot study evaluated the associations between trabecular bone score (TBS) and markers of CVD risk. We enrolled 55 adults with T1D (26 M, age 45.3±9.1 years; 29 F, age 43.65±9.3 years) with mean duration of diabetes 29 years, and 54 age- and gender-matched healthy controls (21M, age 47.2±6.5 years; 33F, age 44.1±7.4 years) from the ongoing Coronary Artery Calcification in Type 1 (CACTI) study. Height, weight, waist circumference (WC), body mass index (BMI), resting systolic and diastolic blood pressures, and blood lipids were measured as previously reported (3). TBS was calculated from the L1-L4 spine BMD using iNsight software version 2.2.1 (TBS iNsight; Medimaps, Switzerland). Pericardial fat (PAT) volume was measured from electron beam CT scans obtained to measure coronary artery calcium using Analyze software version 11.0 (Analyze Direct, Inc, Chicago IL). Visceral (VAT) and subcutaneous (SAT) fat were measured at the L4-L5 space using electron beam CT.

There were no differences in BMI in men (27.3±3.8 vs. 27.0±4.0, p=0.7) and women (25.6±4.0 vs. 24.9±4.0, p=0.2) with T1D compared to controls. Similarly, WC was not different between men and women with T1D and controls. Total cholesterol, low density lipoprotein, and triglyceride levels were lower and high density lipoprotein level was higher in adults with T1D compared to controls.

Age-, sex-, and lumbar spine BMD-adjusted TBS was lower in subjects with T1D compared to controls (1.43±0.01 vs. 1.46±0.01, p=0.04) despite no differences in BMD at the lumbar spine between the two groups. Higher WC (r=-0.23, p=0.0496), total body fat % (r=-0.26, p=0.03), VAT volume (r=-0.34, p=0.004) and PAT volume (r=-0.43, p=0.0002), but not BMI (r=-0.13, p=0.26) or SAT volume (r=-0.06, p=0.59), were associated with lower TBS.

We concluded that trabecular bone quality is lower in adults with T1D. In addition, the findings suggest a link between adiposity and osteoporotic fractures, as measures of central and ectopic fat deposition were associated with lower TBS.


Disclosure: VS: , Dexcom. Nothing to Disclose: LP, PJ, DO, WMK, AA, JKS