Prevalence of Vertebral Fractures in Adults With Type 1 Diabetes: DenSiFy Study (Diabetes Spine Fractures)

Abstract

Context: Vertebral fracture (VF) prevalence up to 24% has been reported among young people with type 1 diabetes (T1D). If this high prevalence is confirmed, individuals with T1D could benefit from preventative VF screening. Objective: We compared the prevalence of VFs between adults with T1D and nondiabetic controls. Methods: This cross-sectional study included 127 adults with T1D, and 65 controls with a similar age, sex, and BMI distribution, from outpatient clinics of 2 tertiary care centers. Vertebral fracture assessment (VFA) by dual-energy x-ray absorptiometry (DXA) was used for prevalent VFs. The modified algorithm-based qualitative (mABQ) method was applied. Bone mineral density (BMD) and trabecular bone score (TBS) were assessed by DXA. Serum bone turnover markers and sclerostin were measured in a subgroup of participants. Results: Participants with T1D (70 women, 57 men) had a mean age of 42.8±14.8 years, median diabetes duration of 25.8 (15.8-34.4) years, mean BMI of 26.6±5.4 kg/m2 and mean HbA1c over the past 3 years of 7.5±0.9%. Controls (35 women, 30 men) had mean age of 42.2±15.9 years and mean BMI of 26.1±5.1 kg/m2. VF prevalence was comparable between groups (2.4% vs 3.1%, P=0.99). TBS, BMD at the total hip and femoral neck, and bone formation and resorption markers were lower while sclerostin levels were similar in participants with T1D vs controls. Conclusion: Our VFA results using the mABQ method do not confirm increased prevalence of VFs in men and women with relatively well-controlled T1D.