# Bone microarchitecture, diabetes and change in bone mineral density in Puerto Rican adults

> **NIH NIH R01** · UNIVERSITY OF MASSACHUSETTS LOWELL · 2022 · $538,876

## Abstract

PROJECT SUMMARY
Recent national data indicate a higher prevalence of osteoporosis (OP) among Hispanics, compared with non-
Hispanic whites or blacks. As one of the fastest growing segments of the U.S. population, this group is
projected to have the largest increase in OP-related fracture from 2005 to 2025. Hispanic adults of Caribbean
origin have been shown to have poorer bone quality than non-Hispanic whites. Puerto Ricans, in particular,
have higher prevalence of OP than previously appreciated. Although higher bone mineral density (BMD) has
been noted in those with type 2 diabetes (T2D), T2D contributes to compromised bone strength, cortical
defects and increased cortical porosity increasing risk of fracture. This is of particular concern for Puerto
Ricans who have a high prevalence of T2D. One mechanism for poor bone quality among those with T2D is
the accumulation of advanced glycation end-products (AGE), which affect bone mechanical properties. Animal
studies suggest that antioxidant activity from vitamin B6 may inhibit AGE formation. Greater plasma pyridoxyl-
5'-phosphate (PLP, vitamin B6) concentration and intake of vitamin B6 has been associated with less bone
loss over time and reduced risk of fracture; but mechanisms are unclear. Trabecular bone score (TBS), a novel
measure of trabecular microarchitecture of the lumbar spine, is indicative of fragility fracture risk, even among
those with normal BMD; however, research on TBS for assessing bone quality is limited and urgently needed.
Further, assessment of bone strength by novel micro-indentation may elucidate differences in bone quality
among T2D at risk for OP. Therefore, our central hypothesis is that Puerto Rican adults with T2D will have
poor bone strength (micro-indentation), and greater loss of TBS at the spine and of BMD at the spine and hip
compared to individuals without T2D; and that this will be moderated by high plasma AGE concentration. Our
secondary hypothesis is that greater plasma PLP will be associated with lower plasma AGE and therefore
higher bone strength (micro-indentation), and less loss of TBS and BMD over time. All available 860 Puerto
Rican adults who participated in the Boston Puerto Rican Osteoporosis Study with valid BMD data will be
invited to participate in the proposed study. Participants will complete a questionnaire, a repeat DXA scan,
undergo bone micro-indentation, skin autofluorescence measurement of AGES and provide a fasting blood
sample. The proposed research is innovative in the inclusion of TBS as a measure of bone quality, micro-
indentation to evaluate bone strength, the examination of AGE as an effect modifier linking diabetes and bone
health, and the consideration of PLP as a factor in AGE in a longitudinal study. This work is urgently needed to
improve our understanding of complex risk factors for bone health, and to provide important information for the
development of future interventions to prevent bone loss and fracture risk, particularly...

## Key facts

- **NIH application ID:** 10242625
- **Project number:** 5R01AR072741-04
- **Recipient organization:** UNIVERSITY OF MASSACHUSETTS LOWELL
- **Principal Investigator:** Katherine L Tucker
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $538,876
- **Award type:** 5
- **Project period:** 2018-08-03 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10242625

## Citation

> US National Institutes of Health, RePORTER application 10242625, Bone microarchitecture, diabetes and change in bone mineral density in Puerto Rican adults (5R01AR072741-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10242625. Licensed CC0.

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