This single center case control study will assess differences in bone structure between women and men with longstanding type 1 diabetes (diabetes duration\>/= 25 years) and healthy controls.
Based on a cross-sectional approach the investigators aim to assess microstructural, biomechanical and densitometric bone characteristics in patients with longstanding type 1 diabetes and age- and sex-matches controls. The investigators examine whether the presence of microvascular disease and/or poor diabetic control is associated with an altered bone microarchitecture and whether any such effect is independent of bone mineral density. Furthermore, the investigators aim to look into the relationship between an altered bone microarchitecture and advanced glycation end product (AGE) formation as well as biochemical markers of bone formation and bone turnover. The study aims to identify type 1 diabetic patients with high fracture risk by assessing the discriminatory power of parameters of cortical and trabecular microstructure measured via high resolution peripheral quantitative computed tomography (HR-pQCT) of the distal radius and tibia and high resolution quantitative computed tomography (HR-QCT) of the proximal femur and tibia with and without adjustment for bone density.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
136
The investigators will perform blood tests in every participant.
The investigators will perform an osteodensitometry in every participant.
The investigators perform the following clinical tests: vibration threshold test, monofilament test, chair rise test and timed up and go test in every participant.
Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel
Basel, Canton of Basel-City, Switzerland
volumetric bone mineral density in mg hydroxyapatite (HA)/ccm
measured by HR-pQCT at the distal radius and tibia
Time frame: through study completion, an average of 6 months
cortical porosity in %
measured by HR-pQCT at the distal radius and tibia
Time frame: through study completion, an average of 6 months
bone stiffness in kilonewton (kN)/mm
a measure of bone strength, measured by HR-pQCT at the distal radius and tibia
Time frame: through study completion, an average of 6 months
failure load in kN
a measure of bone strength, measured by HR-pQCT at the distal radius and tibia
Time frame: through study completion, an average of 6 months
areal bone mineral density of the spine in g/cm2
measured by osteodensitometry (DXA)
Time frame: through study completion, an average of 6 months
areal bone mineral density of the proximal femur in g/cm2
measured by osteodensitometry
Time frame: through study completion, an average of 6 months
areal bone mineral density of the distal radius in g/cm2
measured by osteodensitometry
Time frame: through study completion, an average of 6 months
trabecular bone score of the spine
a measure of bone texture, measured by osteodensitometry
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The investigators will perform HR-QCT measurements of the proximal femur and tibia in every participant.
The investigators will perform HR-pQCT measurements of the distal radius and distal tibia in every participant.
Time frame: through study completion, an average of 6 months
cortical thickness at the mid tibia in cm
the cortical thickness will be measured by pulse-echo ultrasound and high resolution quantitative computed tomography (HR-QCT)
Time frame: through study completion, an average of 6 months
density weighed cortical thickness at the mid tibia in cm
the density weighed cortical thickness will be measured by pulse-echo ultrasound and HR- QCT
Time frame: through study completion, an average of 6 months
bone marrow adiposity in mg/cm3
measured by HR-pQCT
Time frame: through study completion, an average of 6 months
measurement of serum carboxy-terminal collagen crosslinks (CTX) in pg/ml
biochemical marker of bone resorption
Time frame: through study completion, an average of 6 months
measurement of serum n-terminal procollagen type 1 (P1NP) in mcg/l
biochemical marker of bone formation
Time frame: through study completion, an average of 6 months
measurement of serum pentosidine in pmol/m
biochemical marker associated with bone fragility
Time frame: through study completion, an average of 6 months
measurement of serum carboxymethyl-lysine (CML) in pmol/ml
biochemical marker associated with bone fragility
Time frame: through study completion, an average of 6 months
measurement of serum insulin in mU/ml
biochemical marker associated with bone fragility
Time frame: through study completion, an average of 6 months
measurement of serum sclerostin in pg/ml
biochemical marker associated with bone fragility
Time frame: through study completion, an average of 6 months
measurement of serum adiponectin in ng/ml
biochemical marker associated with bone fragility
Time frame: through study completion, an average of 6 months
measurement of serum insulin like growth factor -1 (IGF1) in nM
biochemical marker associated with bone fragility
Time frame: through study completion, an average of 6 months
measurement of serum ultrasensitive c-reactive protein (usCRP) in mg/l
biochemical marker associated with bone fragility
Time frame: through study completion, an average of 6 months
measurement of serum interleukin 6 (IL6) in pg/ml
biochemical marker associated with bone fragility
Time frame: through study completion, an average of 6 months
measurement of serum periostin in ng/ml
biochemical marker associated with bone fragility
Time frame: through study completion, an average of 6 months