Buscar en
Medicina Clínica (English Edition)
Toda la web
Inicio Medicina Clínica (English Edition) Trabecular bone score and 25-hydroxyvitamin D levels in microvascular complicati...
Journal Information
Vol. 158. Issue 7.
Pages 308-314 (April 2022)
Share
Share
Download PDF
More article options
ePub
Visits
30
Vol. 158. Issue 7.
Pages 308-314 (April 2022)
Original article
Trabecular bone score and 25-hydroxyvitamin D levels in microvascular complications of type 2 diabetes mellitus
Índice trabecular óseo y niveles de 25-hidroxivitamina D en las complicaciones microvasculares de la diabetes mellitus tipo 2
Visits
...
Meryam Maamar el Asria, Emilio Pariente Rodrigoa,
Corresponding author
emilio.pariente@scsalud.es

Corresponding author.
, Sara Díaz-Salazar de la Flora, Stefanie Pini Valdiviesob, M. Carmen Ramos Barrónc, José M. Olmos Martínezd, José L. Hernández Hernándezd
a Centro de Salud Camargo-Interior, Universidad de Cantabria, Santander, Spain
b Servicio de Hospitalización Domiciliaria, Hospital Universitario Marqués de Valdecilla, Santander, Spain
c Centro de Salud Camargo-Costa, Universidad de Cantabria, Santander, Spain
d Servicio de Medicina Interna, Unidad de Metabolismo Óseo, Hospital Universitario Marqués de Valdecilla-IDIVAL, Universidad de Cantabria, Santander, Spain
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (4)
Show moreShow less
Tables (2)
Table 1. Clinical characteristics of the patients of the sample.
Table 2. Parameters related to bone metabolism in the patients of the sample.
Show moreShow less
Abstract
Background and objective

Diabetic microvascular disease (MVD) has been associated with increased bone fragility. The objective was to analyse the relationship between MVD and trabecular microstructure – assessed by the trabecular bone score (TBS) – in type 2 diabetic (T2D) patients. A second aim was to know the relationship between vitamin D and MVD.

Patients and methods

Cross-sectional study, which included men >50 years and postmenopausal women participating in a population-based cohort, diagnosed with T2D. The presence of nephropathy, neuropathy and/or retinopathy was classified as MVD+. Clinical and laboratory variables, TBS, 25(OH)D and BMD by DXA, were evaluated. Bivariate and multivariate analysis were performed.

Results

We evaluated 361 patients (51.1% women), 63.8 (9) years old. Of them, 92 were MVD+ and presented poorer metabolic control, longer duration of T2D, lower TBS [1.235 (0.1) vs. 1.287 (0.1); p = 0.007] and lower levels of 25(OH)D [18.3 (7) vs. 21.6 (8) ng/mL; p = 0.0001). There were no differences between MVD+ and MVD− with regard to BMD or P1NP and β-CTX markers. After adjusting for confounders, including HbA1c and duration of T2D, the TBS value in MVD+ was 1.252 (95% CI 1.230–1.274) vs. 1.281 (95% CI 1.267–1.295) in MVD− (p = 0.034). MVD was associated with a 25(OH)D level <20 ng ml with an adjusted OR of 1.88 (95% CI 1.06–3.31; p = 0.028).

Conclusions

The MVD+ patients presented a significantly lower TBS, after adjusting for confounders. Furthermore, multivariable analysis showed a significant relationship between a low 25(OH)D level and a prevalent MVD.

Keywords:
Diabetic microangiopathy
Type 2 diabetes mellitus
Trabecular bone score
25-hydroxyvitamin D
Vitamin D deficiency
Bone metabolic diseases
Resumen
Antecedentes y objetivo

La enfermedad microvascular (EMV) diabética ha sido asociada con una fragilidad ósea incrementada. El objetivo fue analizar la relación entre la EMV y la microestructura trabecular – evaluada mediante el índice trabecular óseo (trabecular bone score, TBS) – en pacientes diabéticos tipo 2 (DM2). Adicionalmente, conocer la relación entre la vitamina D y la EMV.

Pacientes y métodos

Diseño transversal analítico, que incluyó varones > 50 años y mujeres postmenopáusicas con DM2, participantes en una cohorte poblacional. Se clasificó como EMV+ la presencia de nefropatía, neuropatía y/o retinopatía. Fueron analizadas variables clínicas, de laboratorio, el TBS, la 25-hidroxivitamina D [25(OH)D] y la densidad mineral ósea (DMO). Se realizaron análisis bivariable y multivariable.

Resultados

Fueron evaluados 361 pacientes (51,1% mujeres), de 63,8 (9) años. De ellos, 92 tenían EMV, con un peor control metabólico, mayor duración de la DM2, menor TBS (1,235 [0,1] vs. 1,287 [0,1]; p = 0,003) y menores niveles de 25(OH)D (18,3 [7] vs. 21,6 [8] ng/mL; p = 0,0001). No hubo diferencias entre EMV+ y EMV− en la DMO ni en los marcadores P1NP y β-CTX. Tras ajustar por confusores, incluyendo HbA1c y duración de la DM2, el TBS en EMV+ fue 1,252 (IC 95% 1,230–1,274) vs. 1,281 (IC 95% 1,267–1,295) en EMV− (p = 0,034). La EMV se asoció a un nivel de 25(OH)D < 20 ng/mL con una OR ajustada = 1,88 (IC 95% 1,06–3,31; p = 0,028).

Conclusiones

Los pacientes con EMV presentaron un TBS significativamente menor, tras ajustar por confusores. El análisis multivariable mostró asimismo una asociación significativa entre un nivel bajo de 25(OH)D y la EMV prevalente.

Palabras clave:
Microangiopatía diabética
Diabetes mellitus tipo 2
Índice trabecular óseo
25-hidroxivitamina D
Deficiencia de vitamina D
Enfermedades metabólicas óseas

Article

These are the options to access the full texts of the publication Medicina Clínica (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Medicina Clínica (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos