Femoral cortical bone from type 1 diabetes mellitus individuals exhibit impaired osteocyte viability in the periosteal region

Introduction

Type 1 diabetes mellitus (T1DM) patients have an up to 7-fold higher hip fracture risk compared to healthy individuals. The underlying mechanism of impaired bone quality in T1DM is unknown. Osteocytes play a pivotal role in mechanosensation and maintain skeletal homeostasis. Micropetrosis is osteocyte-lacuna mineralisation indicating previous osteocyte death and can delimit the lacuno-canalicular network, possibly resulting in changes in bone quality contributing to increased bone fragility in T1DM.

Material and Methods

We analysed the anterior quadrant from femoral cortices of the mid-diaphysis from 25 individuals (T1DM n=9, 52.5±12.0 years; control n=16, 51.2±10.2 years) by quantitative backscattered electron imaging (qBEI). We determined bone mineral density distribution (BMDD) and mineralised osteocyte-lacunae at the periosteal and endocortical region.

Results

Analysis of BMDD showed a similar degree of mineralisation in T1DM compared to the controls. However, we found two types of mineralised lacunae: fully mineralised and partly mineralised lacunae. We found a higher number of fully mineralised lacunae in the periosteal region in T1DM compared to controls (p=0.038). Moreover, we distinguished the preferred site of micropetrosis accumulation by analysing interstitial and osteonal bone. This anatomical subdivision showed a higher amount of mineralised lacunae within osteons of the periosteal region in T1DM in comparison to controls (p=0.049).

Conclusion

Our data revealed that T1DM is associated with an accumulation of mineralised osteocyte-lacunae. Specifically, within osteons at the periosteal region, osteocyte viability and micropetrosis are more apparent. This finding points to reduced viability of osteocytes in T1DM, which may, in turn, affect bone remodelling and microdamage accumulation.

Conflict of Interest

I declare no conflict of interest.

Publication History

Article published online:
04 November 2021