{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:08:06Z","timestamp":1790654886708,"version":"4.1.0"},"reference-count":83,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T00:00:00Z","timestamp":1611187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Department of Science and Technology, India","award":["CRG\/2018\/002219"],"award-info":[{"award-number":["CRG\/2018\/002219"]}]},{"name":"IMPRINT - Ministry of Human Resource Development, India","award":["IMP\/2019\/000150"],"award-info":[{"award-number":["IMP\/2019\/000150"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Increased bone fragility and reduced energy absorption to fracture associated with type 2 diabetes (T2D) cannot be explained by bone mineral density alone. This study, for the first time, reports on alterations in bone tissue\u2019s material properties obtained from individuals with diabetes and known fragility fracture status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the role of T2D in altering biomechanical, microstructural, and compositional properties of bone in individuals with fragility fracture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Femoral head bone tissue specimens were collected from patients who underwent replacement surgery for fragility hip fracture. Trabecular bone quality parameters were compared in samples of 2 groups, nondiabetic (n = 40) and diabetic (n = 30), with a mean duration of disease 7.5 \u00b1 2.8 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No significant difference was observed in aBMD between the groups. Bone volume fraction (BV\/TV) was lower in the diabetic group due to fewer and thinner trabeculae. The apparent-level toughness and postyield energy were lower in those with diabetes. Tissue-level (nanoindentation) modulus and hardness were lower in this group. Compositional differences in the diabetic group included lower mineral:matrix, wider mineral crystals, and bone collagen modifications\u2014higher total fluorescent advanced glycation end-products (fAGEs), higher nonenzymatic cross-link ratio (NE-xLR), and altered secondary structure (amide bands). There was a strong inverse correlation between NE-xLR and postyield strain, fAGEs and postyield energy, and fAGEs and toughness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The current study is novel in examining bone tissue in T2D following first hip fragility fracture. Our findings provide evidence of hyperglycemia\u2019s detrimental effects on trabecular bone quality at multiple scales leading to lower energy absorption and toughness indicative of increased propensity to bone fragility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgab027","type":"journal-article","created":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T10:03:58Z","timestamp":1611223438000},"page":"e2271-e2289","source":"Crossref","is-referenced-by-count":107,"title":["Investigation of Mechanical, Material, and Compositional Determinants of Human Trabecular Bone Quality in Type 2 Diabetes"],"prefix":"10.1210","volume":"106","author":[{"given":"Praveer","family":"Sihota","sequence":"first","affiliation":[{"name":"Department of Mechanical Engineering, Indian Institute of Technology Ropar, Rupnagar, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram Naresh","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Indian Institute of Technology Ropar, Rupnagar, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4179-4006","authenticated-orcid":false,"given":"Ruban","family":"Dhaliwal","sequence":"additional","affiliation":[{"name":"Metabolic Bone Disease Center, State University of New York, Upstate Medical University, Syracuse, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagadeesh Chandra","family":"Bose","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vandana","family":"Dhiman","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Neradi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shailesh","family":"Karn","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidhartha","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay G","family":"Goni","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishwajeet","family":"Mehandia","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Indian Institute of Technology Ropar, Rupnagar, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Vashishth","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0410-8778","authenticated-orcid":false,"given":"Sanjay Kumar","family":"Bhadada","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7958-8155","authenticated-orcid":false,"given":"Navin","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Indian Institute of Technology Ropar, Rupnagar, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2021,1,21]]},"reference":[{"issue":"8","key":"2021122204523625500_CIT0001","doi-asserted-by":"crossref","first-page":"2073","DOI":"10.1007\/s00198-015-3123-0","article-title":"Oral anti-diabetic drugs and fracture risk, cut to the bone: safe or dangerous? 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