Diabetes Mellitus is Associated with Poor Bone Microarchitecture in Older Adults Residing in Long-Term Care Facilities

Objectives. Both diabetes mellitus (DM) and osteoporosis are very common in older adults who reside in long-term care (LTC) facilities. Nevertheless, few studies have examined the relationship between diabetes and bone quality in this population. The purpose of this study is to determine if bone min...

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Main Authors: Nami Safai Haeri, Mary P. Kotlarczyk, Subashan Perera, Susan L. Greenspan
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Journal of Osteoporosis
Online Access:http://dx.doi.org/10.1155/2022/2522014
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author Nami Safai Haeri
Mary P. Kotlarczyk
Subashan Perera
Susan L. Greenspan
author_facet Nami Safai Haeri
Mary P. Kotlarczyk
Subashan Perera
Susan L. Greenspan
author_sort Nami Safai Haeri
collection DOAJ
description Objectives. Both diabetes mellitus (DM) and osteoporosis are very common in older adults who reside in long-term care (LTC) facilities. Nevertheless, few studies have examined the relationship between diabetes and bone quality in this population. The purpose of this study is to determine if bone mineral density (BMD) or trabecular bone score (TBS) is a better measure of bone quality and skeletal health, in LTC residents with and without a history of DM. Methodology. In this longitudinal cohort study, we examined baseline BMD (lumbar spine, total hip, and femoral neck), TBS, DM, and functional status in 511 LTC residents who were enrolled in two ongoing randomized placebo-controlled osteoporosis clinical trials. Results. On average, participants were older than 80 years and majority were prefrail or frail. Women with DM had greater lumbar spine BMD (1.106 vs 1.017, adjusted difference ± standard error = 0.084 ± 0.023 g/cm2, p=0.0003) and femoral neck BMD (0.695 vs 0.651, 0.027 ± 0.013 g/cm2, p=0.0463), but lesser lumbar spine TBS (1.211 vs 1.266, −0.036 ± 0.016, p=0.0299) compared to women without DM. Total hip BMD was also higher based on descriptive statistics (0.780 vs 0.734, p=0.6255) in diabetic women, although the difference was not statistically significant. Men had similar but attenuated findings. Conclusions. Among LTC residents, those with DM have greater BMD but lower bone quality measured by TBS. TBS should be considered in assessing older patients with DM. However, further studies are required to confirm the findings with respect to fractures.
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spelling doaj-art-e1acde81537a4e0c8207b6e0c78ae85d2025-08-20T02:21:38ZengWileyJournal of Osteoporosis2042-00642022-01-01202210.1155/2022/2522014Diabetes Mellitus is Associated with Poor Bone Microarchitecture in Older Adults Residing in Long-Term Care FacilitiesNami Safai Haeri0Mary P. Kotlarczyk1Subashan Perera2Susan L. Greenspan3Division of Geriatric MedicineDivision of Geriatric MedicineDivision of Geriatric MedicineDivision of Geriatric MedicineObjectives. Both diabetes mellitus (DM) and osteoporosis are very common in older adults who reside in long-term care (LTC) facilities. Nevertheless, few studies have examined the relationship between diabetes and bone quality in this population. The purpose of this study is to determine if bone mineral density (BMD) or trabecular bone score (TBS) is a better measure of bone quality and skeletal health, in LTC residents with and without a history of DM. Methodology. In this longitudinal cohort study, we examined baseline BMD (lumbar spine, total hip, and femoral neck), TBS, DM, and functional status in 511 LTC residents who were enrolled in two ongoing randomized placebo-controlled osteoporosis clinical trials. Results. On average, participants were older than 80 years and majority were prefrail or frail. Women with DM had greater lumbar spine BMD (1.106 vs 1.017, adjusted difference ± standard error = 0.084 ± 0.023 g/cm2, p=0.0003) and femoral neck BMD (0.695 vs 0.651, 0.027 ± 0.013 g/cm2, p=0.0463), but lesser lumbar spine TBS (1.211 vs 1.266, −0.036 ± 0.016, p=0.0299) compared to women without DM. Total hip BMD was also higher based on descriptive statistics (0.780 vs 0.734, p=0.6255) in diabetic women, although the difference was not statistically significant. Men had similar but attenuated findings. Conclusions. Among LTC residents, those with DM have greater BMD but lower bone quality measured by TBS. TBS should be considered in assessing older patients with DM. However, further studies are required to confirm the findings with respect to fractures.http://dx.doi.org/10.1155/2022/2522014
spellingShingle Nami Safai Haeri
Mary P. Kotlarczyk
Subashan Perera
Susan L. Greenspan
Diabetes Mellitus is Associated with Poor Bone Microarchitecture in Older Adults Residing in Long-Term Care Facilities
Journal of Osteoporosis
title Diabetes Mellitus is Associated with Poor Bone Microarchitecture in Older Adults Residing in Long-Term Care Facilities
title_full Diabetes Mellitus is Associated with Poor Bone Microarchitecture in Older Adults Residing in Long-Term Care Facilities
title_fullStr Diabetes Mellitus is Associated with Poor Bone Microarchitecture in Older Adults Residing in Long-Term Care Facilities
title_full_unstemmed Diabetes Mellitus is Associated with Poor Bone Microarchitecture in Older Adults Residing in Long-Term Care Facilities
title_short Diabetes Mellitus is Associated with Poor Bone Microarchitecture in Older Adults Residing in Long-Term Care Facilities
title_sort diabetes mellitus is associated with poor bone microarchitecture in older adults residing in long term care facilities
url http://dx.doi.org/10.1155/2022/2522014
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