Skip to main content
Log in

Phalangeal quantitative ultrasound and metabolic control in pre-menopausal women with Type 1 diabetes mellitus

  • Original Article
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

Background: Several studies have reported increased fracture risk in Type 1 diabetes mellitus (T1 DM). Quantitative Ultrasound (QUS) provides information on the structure and elastic properties of bone, which are important determinants of fracture risk, along with bone mineral density. Aim: To study phalangeal sites by QUS, examine bone turnover markers and analyze association between these factors with metabolic control in a population of pre-menopausal women with T1 DM. Material and methods: Thirty-five T1 DM pre-menopausal women (mean age 34.5±6.8 yr) attending the Diabetic Outpatients Clinic in the Department of Internal Medicine, University of Messina, were consecutively enrolled and divided into two groups, taking into account the mean value of glycated hemoglobin in the last three years. Twenty healthy age-matched women served as controls. Phalangeal ultrasound measurements [Amplitude Dependent Speed of Sound (AD-SoS), Ultrasound Bone Profile Index (UBPI), T-Score, Z-Score] were performed using a DBM Sonic Bone Profiler. Osteocalcin and deoxypyridinoline served as markers of bone formation and bone resorption, respectively. Results: T1 DM women with poor metabolic control showed lower phalangeal QUS values compared to healthy controls (p<0.01) and T1 DM women with good metabolic control (p<0.05). No significant differences in QUS measurements were detected between T1DM women with good metabolic control and healthy controls. Lower bone formation and increased bone resorption, although not statistically significant, were observed in patients with poor metabolic control in comparison to patients with good metabolic control. Conclusions: Poor metabolic control may worsen the quality of bone in T1 DM. Phalangeal QUS could be considered as a tool to screen T1 DM women for osteoporosis in pre-menopausal age.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Albright F, Reifenstein EC. Bone development in diabetic children: a Roentgen study. Am J Med Sci 1948, 174: 313–9.

    Google Scholar 

  2. Schwartz AV. Diabetes mellitus: Does it affect bone? Calcif Tissue Int 2003, 73: 515–9.

    Article  PubMed  Google Scholar 

  3. Hofbauer LC, Brueck CC, Singh SK, Dobnig H. Osteoporosis in patients with diabetes mellitus. J Bone Miner Res 2007, 22: 1317–28.

    Article  PubMed  Google Scholar 

  4. Vestergaard P. Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes — a meta-analysis. Osteoporos Int 2007, 18: 427–44.

    Article  PubMed  Google Scholar 

  5. Gluer CC, Wu CY, Jergas M, Goldstein SA, Genant HK. Three quantitative ultrasound parameters reflect bone structure. Calcif Tissue Int 1994, 55: 46–52.

    Article  PubMed  Google Scholar 

  6. Gluer CC. Quantitative ultrasound techniques for the assessment of osteoporosis: expert agreement on current status. The International Quantitative Ultrasound Consensus Group. J Bone Miner Res 1997, 8: 1280–8.

    Article  Google Scholar 

  7. Wüster C, Albanese C, De Aloysio D, et al. Phalangeal osteosonogrammetry study: age-related changes, diagnostic sensitivity, and discrimination power. The Phalangeal Osteosonogrammetry Study Group. J Bone Miner Res 2000, 15: 1603–14.

    Article  PubMed  Google Scholar 

  8. Gluer CC, Eastell R, Reid DM, et al. Association of five quantitative ultrasound devices and bone densitometry with osteoporotic vertebral fractures in a population-based sample: The OPUS study. J Bone Miner Res 2004, 19: 782–93.

    Article  PubMed  Google Scholar 

  9. Bauer DC, Gluer CC, Cauley JA, et al. Broadband ultrasound attenuation predicts fractures strongly and independently of densitometry in older women: a prospective study. Arch Intern Med 1997, 157: 629–34.

    Article  PubMed  Google Scholar 

  10. Huang C, Ross PD, Yates AJ, et al. Prediction of fracture risk by radiographic absorptiometry and quantitative ultrasound: a prospective study. Calcif Tissue Int 1998, 63: 380–4.

    Article  PubMed  Google Scholar 

  11. Kanis JA, Johnell O, Oden A, De Laet C, De Terlizzi F. Ten-year probabilities of clinical vertebral fractures according to phalangeal quantitative ultrasonography. Osteoporos Int 2005, 16: 1065–70.

    Article  PubMed  Google Scholar 

  12. De Terlizzi F, Battista S, Cavani F, Canè V, Cadossi R. Influence of bone tissue density and elasticity on ultrasound propagation: an in vitro study. J Bone Miner Res 2000, 15: 2458–66.

    Article  PubMed  Google Scholar 

  13. Njeh CF, Fuerst T, Diessel E, Genant HK. Is quantitative ultrasound dependent on bone structure? A reflection. Osteoporos Int 2001, 12: 1–15.

    PubMed  Google Scholar 

  14. Rix M, Andreassen H, Eskildsen P. Impact of peripheral neuropathy on bone density in patients with type 1 diabetes. Diabetes Care 1999, 22: 827–31.

    Article  PubMed  Google Scholar 

  15. Montomoli M, Gonnelli S, Giacchi M. Validation of a food frequency questionnaire for nutritional calcium intake assessment in Italian women. Eur J Clin Nutr 2002, 56: 21–30.

    Article  PubMed  Google Scholar 

  16. Valerio G, del Puente A, Buono P. Quantitative ultrasound of proximal phalanxes in patients with type 1 diabetes mellitus. Diabetes Res Clin Pract 2004, 64: 161–6.

    Article  PubMed  Google Scholar 

  17. Valerio G, Spadaro R, Iafusco D, et al. The influence of gluten free diet on quantitative ultrasound of proximal phalanxes in children and adolescents with type 1 diabetes mellitus and celiac disease. Bone 2008, 43: 322–6.

    Article  PubMed  Google Scholar 

  18. Strotmeyer ES, Cauley JA, Orchard TJ, Steenkiste AR, Dorman JS. Middle-aged premenopausal women with type 1 diabetes have lower bone mineral density and calcaneal quantitative ultrasound than non diabetic women. Diabetes Care 2006, 29: 306–11.

    Article  PubMed  Google Scholar 

  19. Neumann T, Sämann A, Lodes S, et al. Glycaemic control is positively associated with prevalent fractures but not with bone mineral density in patients with Type 1 diabetes. Diabet Med 2011, 28: 872–5.

    Article  PubMed  Google Scholar 

  20. Danielson KK, Elliott ME, LeCaire T, Binkley N, Palta M. Poor glycemic control is associated with low BMD detected in premenopausal women with type 1 diabetes. Osteoporos Int 2009, 20: 923–33.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Dixit PK, Ekstrom RA. Decreased breaking strength of diabetic rat bone and its improvement by insulin treatment. Calcif Tissue Int 1980, 32: 195–9.

    Article  PubMed  Google Scholar 

  22. Goodman WG, Hori MT. Diminished bone formation in experimental diabetes. Relationship to osteoid maturation and mineralization. Diabetes 1984, 33: 825–31.

    Article  PubMed  Google Scholar 

  23. McCabe LR. Understanding the pathology and mechanisms of type 1 diabetic bone loss. J Cell Biochem 2007, 102: 1343–57.

    Article  PubMed  Google Scholar 

  24. Giaccari A, Sorice G, Muscogiuri G. Glucose toxicity: the leading actor in the pathogenesis and clinical history of type 2 diabetes — mechanisms and potentials for treatment. Nutr Metab Cardiovasc Dis 2009, 19: 365–77.

    Article  PubMed  Google Scholar 

  25. Saito M, Marumo K. Collagen cross-links as a determinant of bone quality: a possible explanation for bone fragility in aging, osteoporosis, and diabetes mellitus. Osteoporos Int 2010, 21: 195–214.

    Article  PubMed  Google Scholar 

  26. Horcajada-Molteni MN, Chanteranne B, Lebecque P. Amylin and bone metabolism in streptozotocin-induced diabetic rats. J Bone Miner Res 2001, 16: 958–65.

    Article  PubMed  Google Scholar 

  27. Reid IR. Relationships between fat and bone. Osteoporos Int 2008, 19: 595–606.

    Article  PubMed  Google Scholar 

  28. Dorman JS, Steenkiste AR, Foley TP, et al. for the Familial Autoimmune and Diabetes (FAD) Study. Menopause in type 1 diabetic women: is it premature? Diabetes 2001, 50: 1857–62.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Catalano MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Catalano, A., Morabito, N., Di Vieste, G. et al. Phalangeal quantitative ultrasound and metabolic control in pre-menopausal women with Type 1 diabetes mellitus. J Endocrinol Invest 36, 347–351 (2013). https://doi.org/10.3275/8646

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.3275/8646

Key-words

Navigation