期刊
DIABETES CARE
卷 29, 期 2, 页码 306-311出版社
AMER DIABETES ASSOC
DOI: 10.2337/diacare.29.02.06.dc05-1353
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资金
- NIA NIH HHS [5-T32-AG00181] Funding Source: Medline
- NIDDK NIH HHS [R01 DK44590-05] Funding Source: Medline
OBJECTIVE - To determine whether middle-aged premenopausal women with type 1 diabetes had more self-reported fractures and lower bone mineral density (BMD) compared with nondiabetic women. RESEARCH DESIGN AND METHODS - Participants were premenopausal women aged 35 - 55 years with type 1 diabetes (n = 67; 32.2 +/- 5.3 years duration) and without diabetes (n = 237). Total hip, femoral neck, whole-body, and spine BMD were measured by dual X-ray absorptiometry. Calcaneal broadband ultrasound attenuation (BUA) was assessed with quantitative ultrasound. RESULTS - Women with type 1 diabetes were more likely to report a fracture after age 20 years compared with nondiabetic women (33.3 vs. 22.6%; age-adjusted odds ratio 1.89 [95% CI 1.02 - 3.49]). Type 1 diabetes was associated with lower total hip BMD (0.890 vs. 0.961 g/cm(2); P < 0.001), femoral neck BMD (0.797 vs. 0.847 g/cm(2); p = 0.001), whole-body BMD (1.132 vs. 1.165 g/cm(2); p < 0.01), and lower calcaneal BUA (71.6 vs. 84.9 dB/MHz; P < 0.001) after multivariate adjustment. BMD was 3-8% lower in type 1 diabetic compared with control women and calcaneal BUA was 15% lower. Spine BMD and biomarkers of bone remodeling were not significantly different between groups. In the type1 diabetic women, reduced monofilament detection and blindness were both associated with lower BMD. CONCLUSIONS - Lower BMD in premenopausal women with type 1 diabetes may substantially increase their risk of developing osteoporosis after menopause. Type 1 diabetic women should be targeted for osteoporosis screening and possible fracture prevention as they transition through menopause.
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