{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T16:39:36Z","timestamp":1769272776490,"version":"3.49.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"DCCT\/EDIC collaborative study","award":["DP3 DK114812"],"award-info":[{"award-number":["DP3 DK114812"]}]},{"name":"Division of Diabetes Endocrinology and Metabolic Diseases of the National Institute of Diabetes and Digestive and Kidney Diseases","award":["U01 DK094176"],"award-info":[{"award-number":["U01 DK094176"]}]},{"name":"Division of Diabetes Endocrinology and Metabolic Diseases of the National Institute of Diabetes and Digestive and Kidney Diseases","award":["U01 DK094157"],"award-info":[{"award-number":["U01 DK094157"]}]},{"DOI":"10.13039\/100000053","name":"National Eye Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000053","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurologic Disorders and Stroke","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"crossref"}]},{"name":"General Clinical Research Centers Program"},{"name":"Clinical Translational Science Center Program"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The mechanism for bone fragility in type 1 diabetes (T1D) is unclear. We performed advanced analyses on HR-pQCT images from participants with T1D (n\u2009=\u2009183, 59.5\u2009\u00b1\u20097.0\u00a0yr, 50.8% female, T1D duration 38.0\u2009\u00b1\u20094.8\u00a0yr) enrolled in the Epidemiology of Diabetes Interventions and Complications (EDIC) study and a demographically similar group of nondiabetic controls (n\u2009=\u200994, 60.5\u2009\u00b1\u20098.2\u00a0yr, 65.6% female). Between participants and controls, we compared trabecular morphology by individual trabecula segmentation (ITS) analysis (decomposes trabeculae into plate-like and rod-like structures), and assessed cortical topology by cortical pore skeletonization (CPS) analysis (classifies pores as slab-like or tube-like and analyzes connectivity) and by cortical laminar analysis (CLA) (quantifies distribution, number, and area of pores). By ITS, EDIC participants had worse trabecular morphology with lower plate-rod bone volume ratio (radius: 0.36\u2009\u00b1\u20090.21 vs 0.41\u2009\u00b1\u20090.25 [p\u2009=\u2009.031]; tibia: 0.75\u2009\u00b1\u20090.42 vs 0.88\u2009\u00b1\u20090.52 [p\u2009=\u2009.016]), plate tissue fraction (radius: 0.25\u2009\u00b1\u20090.10 vs 0.27\u2009\u00b1\u20090.10 [p\u2009=\u2009.020]; tibia: 0.40\u2009\u00b1\u20090.12 vs 0.43\u2009\u00b1\u20090.14 [p\u2009=\u2009.040]), and higher rod tissue fraction (radius: 0.75\u2009\u00b1\u20090.10 vs 0.73\u2009\u00b1\u20090.10 [p\u2009=\u2009.020]; tibia: 0.60\u2009\u00b1\u20090.12 vs 0.57\u2009\u00b1\u20090.14 [p\u2009=\u2009.040]) compared with controls. Epidemiology of Diabetes Interventions and Complications participants also had worse cortical pore network topology by CPS compared with controls, with increased tube-tube junctions (81.07\u2009\u00b1\u200974.84 vs 59.90\u2009\u00b1\u200945.25 [p\u2009=\u2009.017]) at the radius, and a higher ratio of slab-like to tube-like pores (0.490\u2009\u00b1\u20090.057 vs 0.472\u2009\u00b1\u20090.071 [p\u2009=\u2009.013]) at the tibia. By CLA, EDIC participants had higher pore size at midcortical (0.039\u2009\u00b1\u20090.007 vs 0.038\u2009\u00b1\u20090.007\u00a0mm2 [p\u2009=\u2009.005]) and periosteal layers (0.037\u2009\u00b1\u20090.005 vs 0.035\u2009\u00b1\u20090.006\u00a0mm2 [p\u2009&amp;lt;\u2009.001]), a biomechanically detrimental pattern. Among EDIC participants, higher HbA1c and advanced glycation end products, as well as kidney disease, retinopathy, and neuropathy, were associated with unfavorable trabecular morphology and cortical pore network connectivity. These findings reveal novel microarchitectural abnormalities previously associated with reduced mechanical properties of bone in participants with long-standing T1D, in association with modifiable diabetes risk factors. Trial registration: Clinicaltrials.gov NCT00360815 and NCT00360893.<\/jats:p>","DOI":"10.1093\/jbmrpl\/ziaf167","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T12:26:09Z","timestamp":1760617569000},"source":"Crossref","is-referenced-by-count":1,"title":["Bone microarchitecture assessed by High-resolution peripheral quantitative computed tomography in type 1 diabetes: the Diabetes Control and Complications Trial\/Epidemiology of Diabetes Interventions and Complications study"],"prefix":"10.1093","volume":"9","author":[{"given":"Mishaela","family":"Rubin","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Columbia University Irving Medical Center , New York, NY 10032, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7327-6425","authenticated-orcid":false,"given":"Galateia","family":"Kazakia","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical 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Biostatistics Center, George Washington University , Bethesda, MD 20817, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian H","family":"de Boer","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of Washington , Seattle, WA 98195, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4978-0717","authenticated-orcid":false,"given":"Sanchita","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Columbia University Irving Medical Center , New York, NY 10032, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6343-4944","authenticated-orcid":false,"given":"Andrew","family":"Burghardt","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Imaging, University of California San Francisco , San Francisco, CA 94143, 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