Trabecular Bone Score Enhances Bone Health Assessment in Postmenopausal Women with Type 2 Diabetes: Study Finds

The study, published in the Indian Journal of Endocrinology and Metabolism, showed that postmenopausal women with type 2 diabetes had significantly lower trabecular bone scores despite having similar areal bone mineral density (aBMD) as non-diabetic and prediabetic individuals. TBS negatively correlated with HbA1c levels and diabetes duration, highlighting its relevance in fracture risk assessment. The researchers suggest that TBS incorporation alongside BMD may improve bone health evaluation in this population.

The researchers note that type 2 diabetes mellitus (T2DM) is associated with a higher risk of fragility fractures, even when the areal bone mineral density (aBMD) remains normal or elevated compared to non-diabetic individuals. This discrepancy has led to growing interest in the trabecular bone score as a potential alternative for assessing bone health in this population. To explore its clinical utility, Dr. Sanjay K. Bhadada, Department of Endocrinology, PGIMER, Chandigarh, India, and colleagues evaluated TBS in postmenopausal women with T2DM and compared it with non-diabetic individuals, aiming to provide deeper insights into bone quality and fracture risk assessment.

For this purpose, the researchers conducted a cross-sectional study involving 101 individuals with T2DM and 101 without overt diabetes, including 43 with prediabetes and 58 with normal glucose levels. All participants underwent a detailed medical history assessment, physical examination, biochemical testing, and a dual-energy X-ray absorptiometry (DXA) scan with TBS measurement to evaluate bone health.

Key Findings:

• Postmenopausal women with T2DM showed no significant difference in aBMD levels compared to those with prediabetes or normoglycaemia.
• Despite similar aBMD across groups, the mean TBS value was significantly lower in the T2DM group.
• Higher glycated haemoglobin (HbA1c) levels and longer diabetes duration were significantly associated with lower TBS values.

The researchers highlighted the importance of incorporating the Trabecular Bone Score alongside aBMD assessments for a more comprehensive evaluation of bone health in individuals with T2DM. Their findings suggest that TBS could be a valuable marker of bone quality, particularly when aBMD alone does not accurately reflect fracture risk.

"Both glycaemic control and diabetes duration significantly influence TBS values, further emphasizing the need for tailored bone health assessments in this population. Future studies with larger cohorts are needed to validate these findings and explore the clinical utility of TBS in fracture risk prediction for individuals with T2DM," the researchers concluded.

Reference:

Aggarwal, Tanushi; Shah, Ravi1; Pal, Rimesh1; Rastogi, Ashu1; Singla, Veenu2; Bhadada, Sanjay K.1. Trabecular Bone Score in Asian-Indian Post-menopausal Women Across the Spectrum of Hyperglycaemia: Insights from a Cross-Sectional Study. Indian Journal of Endocrinology and Metabolism 29(1):p 43-48, Jan–Feb 2025. | DOI: 10.4103/ijem.ijem_310_24