ADA Scientific Sessions 2025 Abstract · Jun 13, 2025
Bone Microarchitectural Deterioration in Japanese Adults with Type 1 Diabetes Assessed by Second-Generation HR-pQCT Exhibits Greater Impact on Males Than Females
By KUBO M, NAKAJI E, HORIE I et al.
Introduction and Objective: Fracture risk in type 1 diabetes (T1D) involves lower bone mineral density (BMD) and deterioration of bone microarchitecture, but data in Asians is limited. We investigated bone microarchitecture and its associated factors in Japanese with T1D using high-resolution peripheral quantitative computed tomography (HR-pQCT). Methods: We recruited individuals with T1D aged ≥20 years, who had not been treated with anti-osteoporosis drugs. Microstructures in distal radius and tibia were evaluated by HR-pQCT (Xtreme CT II®) in subjects with T1D and those without diabetes, matching 1:1 for age, sex, height, and BMI. Results: 58 adults with T1D (age 52±13 ys, duration 14±12 ys) were enrolled. In trabecular (Tb) bone in tibia, compared to non-diabetes, T1D subjects showed significant decreases in volumetric BMD (vBMD) and Tb number (Tb.N), and a significant increase in Tb separation (Tb.Sp). No significant differences were observed in cortical (Ct) values of tibia between T1D and non-diabetes. All Tb/Ct values of radius showed a similar tendency to those of tibia, but without significant differences between T1D and non-diabetes. Age was negatively correlated with Tb.vBMD and Tb.N, and positively correlated with Tb.Sp. Total insulin dose was negatively and positively correlated with Tb.N and Tb.Sp, respectively. Deterioration of Ct bone in vBMD, thickness, and porosity was observed in subjects complicated with neuropathy. In sub-analysis of males, in addition to Tb finding observed in all subjects, Ct vBMD and Ct thickness were significantly decreased in T1D than non-diabetes. Complications of neuropathy or retinopathy showed significant effects on Tb and Ct deterioration in males but not females. Conclusion: T1D is associated with microarchitectural deterioration in Tb rather than Ct bone, with a stronger impact in males. Microvascular complications may accelerate the risk especially in males. Disclosure: M. Kubo: None. E. Nakaji: None. I. Horie: None. K. Chiba: None. M. Osaki: None. A. Kawakami: None.