Association between pre-diabetes, type 2 diabetes and trabecular bone score: The Vietnam Osteoporosis Study

Aims: Trabecular bone score (TBS) is a surrogate indicator of bone microarchitecture. The present study sought to examine the association between type 2 diabetes (T2D) and trabecular bone score (TBS) in adult Vietnamese men and women. Methods: The study was part of the Vietnam Osteoporosis Study, in which 2702 women and 1398 men aged >= 30 years were recruited from the general community in Ho Chi Minh City. HbA(1c) levels were measured by the ADAMS (TM) A(1c) HA-8160 (Arkray, Kyoto, Japan), and classified into 3 groups: normal if HbA(1c) < 5.7%; pre-diabetes (5.7-6.4%); and diabetes (> 6.4%). TBS was evaluated by iNsight Software, version 2.1 (Medimaps, Merignac, France) on lumbar spine BMD scan (Hologic Horizon). Differences in TBS between diabetic status were analyzed by the multivariable regression model with adjustment for age and body mass index. Results: The prevalence of pre-diabetes and diabetes in men and women was 30.2% and 8.3%, respectively. In women, TBS was lower in pre-diabetes (-0.02; P < 0.001) and diabetes (-0.02; P < 0.001) compared with normal individuals. In men, there was no statistically significant difference in TBS between diabetic status. Moreover, TBS was significantly inversely correlated with HbA(1c) levels in women (P = 0.01), but not in men (P = 0.89). Conclusion: Women, but not men, with type 2 diabetes and pre-diabetes have lower TBS than individuals without diabetes. These data suggest that diabetes and prediabetes are associated with deterioration of bone microarchitecture. (C) 2019 Published by Elsevier B.V.