Prevalence of Vertebral Fractures in Adults With Type 1 Diabetes: DenSiFy Study (Diabetes Spine Fractures)

Context Vertebral fracture (VF) prevalence up to 24% has been reported among young people with type 1 diabetes (T1D). If this high prevalence is confirmed, individuals with T1D could benefit from preventative VF screening. Objective We compared the prevalence of VFs between adults with T1D and nondiabetic controls. Methods This cross-sectional study included 127 adults with T1D, and 65 controls with a similar age, sex, and BMI distribution, from outpatient clinics of 2 tertiary care centers. Vertebral fracture assessment (VFA) by dual-energy x-ray absorptiometry (DXA) was used for prevalent VFs. The modified algorithm-based qualitative (mABQ) method was applied. Bone mineral density (BMD) and trabecular bone score (TBS) were assessed by DXA. Serum bone turnover markers and sclerostin were measured in a subgroup of participants. Results Participants with T1D (70 women, 57 men) had a mean age of 42.8 +/- 14.8 years, median diabetes duration of 25.8 (15.8-34.4) years, mean BMI of 26.6 +/- 5.4 kg/m(2) and mean HbA(1c) over the past 3 years of 7.5 +/- 0.9%. Controls (35 women, 30 men) had mean age of 42.2 +/- 15.9 years and mean BMI of 26.1 +/- 5.1 kg/m(2). VF prevalence was comparable between groups (2.4% vs 3.1%, P = 0.99). TBS, BMD at the total hip and femoral neck, and bone formation and resorption markers were lower while sclerostin levels were similar in participants with T1D vs controls. Conclusion Our VFA results using the mABQ method do not confirm increased prevalence of VFs in men and women with relatively well-controlled T1D.

Automated summary

The prevalence of vertebral fractures is comparable between individuals with well-controlled T1D and nondiabetic controls, but T1D patients have lower bone density and trabecular bone score.