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Different health behaviours and clinical factors associated with bone mineral density and bone turnover in premenopausal women with and without type 1 diabetes
Author(s) -
Kujath Amber S.,
Quinn Lauretta,
Elliott Mary E.,
LeCaire Tamara J.,
Binkley Neil,
Molino Andrea R.,
Danielson Kirstie K.
Publication year - 2015
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.2627
Subject(s) - medicine , bone mineral , type 1 diabetes , bone remodeling , osteoporosis , diabetes mellitus , endocrinology , bone resorption , body mass index , heel , type 2 diabetes , physiology , anatomy
Background Women with type 1 diabetes (T1DM) have an elevated fracture risk. We therefore compared the associations of health behaviours and clinical factors with bone mineral density (BMD) and bone remodelling between premenopausal women with and without T1DM to inform potential interventions. Methods Participants included women with T1DM ( n = 89) from the Wisconsin Diabetes Registry Study and age‐matched and race‐matched controls without diabetes ( n = 76). Peripheral (heel and forearm) and central (hip and spine) BMD, markers of bone resorption and formation, bone cell signalling, glycaemic control, and kidney function were assessed. Health behaviours and medical history were self‐reported. Results In controls, but not in women with T1DM, older age was associated with lower bone resorption ( p ≤ 0.006) and formation ( p = 0.0007). Body mass index was positively associated with heel and forearm BMD in both controls and T1DM women (all p < 0.0001), but with hip and spine BMD only in controls ( p ≤ 0.005). Worse glycaemic control during the previous 10 years, greater alcohol intake, history of smoking, and lack of physical activity were associated with poorer bone outcomes only in women with T1DM (all p ≤ 0.002), whereas use of hormonal contraceptives was related to low bone formation in both women with and without T1DM (all p ≤ 0.006). Diabetes duration, insulin dose, residual C‐peptide, and kidney function were not associated with bone in T1DM. Conclusions Age and body mass index may not predict bone health in T1DM women. However, modifiable behaviours such as optimizing glycaemic control, limiting substance and hormonal contraceptive use, and increasing physical activity may improve bone health in T1DM women. Copyright © 2014 John Wiley & Sons, Ltd.