Prevalence of Vertebral Fractures in Patients With Type 1 Diabetes
Prevalence of Vertebral Fractures in Patients With Type 1 Diabetes
Background : Type 1 diabetes is associated with an increased risk of fractures. The
 mechanisms accounting for this bone fragility are not yet fully understood. The lower bone
 mineral density (BMD) observed in individuals with type 1 diabetes cannot solely explain the
 higher fracture incidence. Bone microarchitecture defects significantly contribute to bone
 fragility. Few studies assessed spine fractures in type 1 diabetes.

 This cross-sectional multicenter case-control study aims (1) to evaluate the prevalence of
 asymptomatic vertebral fractures in individuals with type 1 diabetes in comparison to age-
 and sex-matched healthy controls; (2) to compare individuals with diabetes with vertebral
 fractures and those without vertebral fracture using clinical, biochemical and radiological
 parameters.
Individuals with type 1 diabetes

 Inclusion Criteria:

 -  Diagnosis of type 1 diabetes for at least 5 years;

 -  Age 20 years and older.

 Exclusion Criteria:

 -  Pregnancy or breastfeeding;

 -  Conditions associated with bone disease (significant liver disease, intestinal
 malabsorption other than celiac disease, organ transplant, active cancer, rheumatoid
 arthritis, hyperthyroidism, hypothyroidism with abnormal TSH, hyperparathyroidism,
 hypoparathyroidism, acromegaly, Cushing syndrome, adrenal insufficiency);

 -  Any of these medications in the past 6 months : glucocorticoids ≥ 7,5 mg
 prednisone/day or equivalency ≥ 3 months, aromatase inhibitors, antiandrogens,
 antiepileptic drugs, anticoagulants, SGLT-2 (sodium-glucose cotransporter-2)
 inhibitors, thiazolidinediones;

 -  Past medical history of traumatic vertebral fracture;

 -  Inability to consent.

 Healthy controls

 Inclusion Criteria:

 -  Age 20 years and older.

 Exclusion Criteria:

 -  As above (as individuals with diabetes), and :

 -  Diagnosis of diabetes or prediabetes;

 -  Celiac disease;

 -  Chronic kidney disease (CrCl < 60 mL/min);

 -  Any of theses medications in the past 6 months : biphosphonates, teriparatide,
 denosumab, calcitonin;

 -  Past medical history of fragility fracture.