Association Between Muscle Status and Bone Size, Density, and Strength in Type 1 Diabetes: A Cross-sectional Study

OBJECTIVE: Muscle mass and function are impaired in type 1 diabetes (T1D); however, the relevance to bone health is unknown. This study aimed to examine the relationship between muscle mass, muscle strength, and bone in adults with childhood onset of T1D. METHODS: This cross-sectional study population includes 111 Danish men and women with T1D onset before age 18 years and 37 sex- and age-matched controls. Lean mass was assessed through dual-energy x-ray absorptiometry, and hand grip strength was measured using a dynamometer. Bone mineral density (BMD), bone size, and bone material strength index were assessed by dual-energy x-ray absorptiometry, high-resolution peripheral quantitative computed tomography, and microindentation. RESULTS: Participants had a median age of 43.2 years and body mass index of 26.9 kg/m2, with no differences between groups. Total and appendicular lean mass were comparable in persons with and without T1D (P = .41 and P = .75), as was grip strength (P = .52). BMD, bone size (cortical area and perimeter), and bone material strength index did not differ between groups (P > .05). Within the T1D group, appendicular lean mass/height2 was positively associated with femoral neck BMD (R2 = 0.12) and total hip BMD (R2 = 0.337). Similarly, grip strength was associated with femoral neck-BMD (R2 = 0.104), and total hip-BMD (R2 = 0.137). The associations between muscle indices and BMD measures did not differ significantly between groups. CONCLUSION: We observed a strong association between muscle and bone regardless of T1D status. Overall, the associations did not differ between the T1D and control groups, suggesting that the muscle-bone crosstalk is not affected by T1D.