Microarchitecture, Bone Strength and Fracture Risk in Long-term Type 1 Diabetes

NCT ID: NCT03751839

Last Updated: 2021-07-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

136 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-10-01

Study Completion Date

2021-07-01

Brief Summary

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This single center case control study will assess differences in bone structure between women and men with longstanding type 1 diabetes (diabetes duration\>/= 25 years) and healthy controls.

Detailed Description

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Based on a cross-sectional approach the investigators aim to assess microstructural, biomechanical and densitometric bone characteristics in patients with longstanding type 1 diabetes and age- and sex-matches controls. The investigators examine whether the presence of microvascular disease and/or poor diabetic control is associated with an altered bone microarchitecture and whether any such effect is independent of bone mineral density. Furthermore, the investigators aim to look into the relationship between an altered bone microarchitecture and advanced glycation end product (AGE) formation as well as biochemical markers of bone formation and bone turnover. The study aims to identify type 1 diabetic patients with high fracture risk by assessing the discriminatory power of parameters of cortical and trabecular microstructure measured via high resolution peripheral quantitative computed tomography (HR-pQCT) of the distal radius and tibia and high resolution quantitative computed tomography (HR-QCT) of the proximal femur and tibia with and without adjustment for bone density.

Conditions

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Type 1 Diabetes Mellitus

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Identical diagnostic procedures will be performed in participants with type 1 diabetes and age- and sex-matched controls.
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Diagnostic

The investigators will examine all participants in the same way by performing biochemical tests, clinical tests, osteodensitometry, HRQCT and HRpQCT measurements.

Group Type EXPERIMENTAL

Biochemical Tests

Intervention Type DIAGNOSTIC_TEST

The investigators will perform blood tests in every participant.

Osteodensitometry

Intervention Type DIAGNOSTIC_TEST

The investigators will perform an osteodensitometry in every participant.

Clinical Tests

Intervention Type DIAGNOSTIC_TEST

The investigators perform the following clinical tests: vibration threshold test, monofilament test, chair rise test and timed up and go test in every participant.

HR-QCT

Intervention Type DIAGNOSTIC_TEST

The investigators will perform HR-QCT measurements of the proximal femur and tibia in every participant.

HR-pQCT

Intervention Type DIAGNOSTIC_TEST

The investigators will perform HR-pQCT measurements of the distal radius and distal tibia in every participant.

Interventions

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Biochemical Tests

The investigators will perform blood tests in every participant.

Intervention Type DIAGNOSTIC_TEST

Osteodensitometry

The investigators will perform an osteodensitometry in every participant.

Intervention Type DIAGNOSTIC_TEST

Clinical Tests

The investigators perform the following clinical tests: vibration threshold test, monofilament test, chair rise test and timed up and go test in every participant.

Intervention Type DIAGNOSTIC_TEST

HR-QCT

The investigators will perform HR-QCT measurements of the proximal femur and tibia in every participant.

Intervention Type DIAGNOSTIC_TEST

HR-pQCT

The investigators will perform HR-pQCT measurements of the distal radius and distal tibia in every participant.

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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dual energy x-ray absorptiometry (DXA scan)

Eligibility Criteria

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Inclusion Criteria

* women and men with longstanding type 1 diabetes (age 40-80 years, BMI 18-37 kg/m2 and age- and sex matched non-diabetic controls
* presence of type 1 diabetes for at least 25 years (defined by history of Insulin treatment)

Exclusion Criteria

* Patients unable to give written informed consent, e.g. with severe dementia or patients not understanding German (or other local language)
* Any medical or psychiatric condition which would preclude the participant from adhering to the protocol
* Idiopathic or premenopausal osteoporosis or coexisting metabolic bone disease (e.g. Paget“s disease, primary hyperparathyroidism)
* Previous treatment with osteoporosis medication (bisphosphonates, denosumab) or intake of medications that are known to affect bone metabolism (e.g. steroids, anticonvulsants) within 6 months prior to enrollment
* Patients with medical conditions known to affect bone health ( e.g. metastatic bone disease, celiac disease, inflammatory bone disease, hypogonadism, thyrotoxicosis, hypercortisolism, chronic kidney disease stage IV and V (KDIGO), liver dysfunction (serum aspartate amino transferase (ASAT) \>3 times the upper limit of normal)
* Inability to keep the extremities still for a few minutes of an HR-pQCT examination (e.g. Parkinson disease, spastic syndrome)
* Pregnant or breastfeeding women
Minimum Eligible Age

40 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Insel Gruppe AG, University Hospital Bern

OTHER

Sponsor Role collaborator

University Hospital Schleswig-Holstein

OTHER

Sponsor Role collaborator

University Hospital, Basel, Switzerland

OTHER

Sponsor Role collaborator

Christian Meier

OTHER

Sponsor Role lead

Responsible Party

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Christian Meier

Prof. Dr. med. Christian Meier

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Christian Meier, Prof.

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Basel, Switzerland

Locations

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Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel

Basel, Canton of Basel-City, Switzerland

Site Status

Countries

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Switzerland

Other Identifiers

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EKNZ 2018-01517

Identifier Type: -

Identifier Source: org_study_id

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