Type 1 diabetes (T1D) is an autoimmune
disease requiring lifelong insulin treatment. Having T1D increases the risk of
death, especially in women with T1D.
Heart disease and fractures due to
osteoporosis (brittle bones) are the leading causes of death in women with T1D.
Both diseases share certain common risk factors such as age, menopause,
smoking, physical inactivity, and diabetes. Research studies have demonstrated
a link between heart disease and osteoporosis in the general population.
Population-based studies have shown that loss of bone mineral density (BMD) in
elderly women is associated with higher heart disease mortality. Moreover,
studies have shown a reduction in heart disease risk by treating osteoporosis
with bisphosphonates. Since high blood sugar and low estrogen levels are associated
with higher risk for both heart disease and osteoporosis, we hypothesize that
postmenopausal women with T1D will have lower BMD at common fractured sites and
more extensive signs of early heart disease than postmenopausal women without
diabetes. We also hypothesize that bone and inflammatory markers measured in
the blood will predict the occurrence of these two diseases.
Consistent with our hypotheses, we are
planning to measure BMD and early signs of heart disease in 50 postmenopausal
women T1D and 50 postmenopausal women without diabetes. We will assess relevant medical, personal,
family and diabetes history, treatment and complications, and history of falls
and fractures in addition to measuring BMD at commonly fractured sites and
comprehensive blood work including markers for inflammation and bone
metabolism. We will correlate BMD and these markers with measures of heart
The findings of this clinical study will
improve our understanding of the association between bone and heart health in
postmenopausal women with T1D and will help to design future studies to
identify biomarkers to screen for both diseases to prevent illness and death
associated with them.