To investigate the associations between diabetes status and bone microarchitecture, volumetric BMD, and strength in older men, highlighting the implications for fracture risk.
Key Findings:
Older men with T2DM had a smaller total cross-sectional area at the distal and diaphyseal tibia compared to nondiabetic men, which may increase fracture risk.
T2DM was associated with lower cortical area at the distal and diaphyseal tibia, indicating potential structural weaknesses.
Cortical porosity, cortical thickness, and trabecular indices did not differ significantly by T2DM status, suggesting other factors may influence bone quality.
Insulin use was linked to poorer cortical measurements and lower bone strength, indicating a need for careful management of T2DM.
Interpretation:
Reduced cross-sectional area may contribute to the higher fracture risk in older men with T2DM, although no direct association with nonvertebral fractures was found, emphasizing the need for further investigation.
Limitations:
Low number of nonvertebral fractures reported (n = 26 in 23 T2DM men), which may limit the robustness of fracture risk conclusions.
Study primarily focused on older White men, limiting generalizability and potential biases.
Conclusion:
Further research is needed to confirm findings and explore mechanisms behind changes in bone size in T2DM patients, particularly in diverse populations.
