Martinez-Montoro, Jose IgnacioGarcia-Fontana, BeatrizGarcia-Fontana, CristinaMuñoz-Torres, Manuel2023-05-032023-05-032022-04-13Martínez-Montoro JI, García-Fontana B, García-Fontana C, Muñoz-Torres M. Evaluation of Quality and Bone Microstructure Alterations in Patients with Type 2 Diabetes: A Narrative Review. J Clin Med. 2022 Apr 14;11(8):2206.2077-0383http://hdl.handle.net/10668/21271Bone fragility is a common complication in subjects with type 2 diabetes mellitus (T2DM). However, traditional techniques for the evaluation of bone fragility, such as dual-energy X-ray absorptiometry (DXA), do not perform well in this population. Moreover, the Fracture Risk Assessment Tool (FRAX) usually underestimates fracture risk in T2DM. Importantly, novel technologies for the assessment of one microarchitecture in patients with T2DM, such as the trabecular bone score (TBS), high-resolution peripheral quantitative computed tomography (HR-pQCT), and microindentation, are emerging. Furthermore, different serum and urine bone biomarkers may also be useful for the evaluation of bone quality in T2DM. Hence, in this article, we summarize the limitations of conventional tools for the evaluation of bone fragility and review the current evidence on novel approaches for the assessment of quality and bone microstructure alterations in patients with T2DM.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/bone fragilitybone qualitybone structurefracture risktype 2 diabetes mellitusHumansCancellous BoneDiabetes Mellitus, Type 2Absorptiometry, PhotonFractures, BoneRisk AssessmentBiomarkersTomographyresearch article35456299open accessAbsorciometría de fotónBiomarcadoresDiabetes Mellitus tipo 2Fracturas óseasHueso esponjosoHumanosMedición de riesgoTomografía10.3390/jcm11082206PMC9024806https://www.mdpi.com/2077-0383/11/8/2206/pdf?version=1650260878https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9024806/pdf