Associations of insulin resistance and insulin secretion with bone mineral density and osteoporosis in a general population

Abstract

We investigated the associations of insulin resistance and β-cell secretion with bone mineral density (BMD) and osteoporosis using data from the National Health and Nutrition Examination Survey. Data on BMD assessed using dual-energy x-ray absorptiometry from 5292 participants were analyzed. Insulin resistance and β-cell secretion were assessed using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and β-cell function (HOMA-β), respectively. We divided the study population into four groups according to HOMA-IR (<2 vs. ≥ 2) and HOMA-β (<100 vs. ≥ 100). BMD and T score at the lumbar spine, hip joint, and femur were used for analyses. Osteoporosis was defined as a T score ≤ -2.5. Logistic regression analyses were conducted to examine the associations of HOMA-IR and HOMA-β with osteoporosis, and the joint effects of HOMA-IR and HOMA-β on osteoporosis. We found a positive association between HOMA-IR and osteoporosis in participants with a HOMA-β ≥ 100 (OR 8.773, 95% CI 2.160-35.637, p=0.002 at the femoral neck). A negative association between HOMA-β and osteoporosis was noted in those with a HOMA-IR <2 (OR 0.183, 95% CI 0.038-0.882, p=0.034 at the femoral neck). Compared with participants who had HOMA-IR <2 and HOMA-β <100, those with HOMA-IR <2 and HOMA-β ≥ 100 had a lower risk of osteoporosis (OR 0.126, 95% CI 0.020-0.805, p=0.032 at the femoral neck). In conclusion, the association between HOMA-β and BMD/osteoporosis changed as HOMA-IR increased. HOMA-β was negatively associated with osteoporosis when HOMA-IR <2. The association was not significant when HOMA-IR ≥ 2.

The crucial role and mechanism of insulin resistance in metabolic disease

“…Essential features of the association between cirrhosis and IR include endocrine dysregulation, liver inflammation, changes in muscle mass and composition, changes in the gut microbiota, and permeability (78). IR may also affect the association between insulinemia and bone mass, and Yi-Hsiu Fu et al found an increased risk of osteoporosis when HOMA-b≥100 and HOMA-IR≥2 in a diverse population (79). Additionally, IR is a crucial risk factor for deterioration of renal function in non-diabetic chronic kidney disease (CKD) and hypertension (80).…”

“…IR may also affect the association between insulinemia and bone mass, and Yi-Hsiu Fu et al. found an increased risk of osteoporosis when HOMA-β≥100 and HOMA-IR≥2 in a diverse population ( 79 ). Additionally, IR is a crucial risk factor for deterioration of renal function in non-diabetic chronic kidney disease (CKD) and hypertension ( 80 ).…”

A Review on the Crosstalk between Insulin and Wnt/β-Catenin Signalling for Bone Health

“…An inverse relationship between glycated haemoglobin, insulin level, and insulin resistance with the trabecular bone score was reported in non-diabetic postmenopausal women [4]. In another study, a positive association was observed between insulin resistance and osteoporosis, whereas a negative relationship was noted between β-cell function and osteoporosis among Taiwanese participants [5]. In patients with type 2 diabetes mellitus (T2DM), those receiving oral glucose-lowering medication and longacting insulin displayed higher spine bone mineral density (BMD) and serum calcium levels compared to those receiving oral glucose-lowering medication only [6].…”

Association between fibrinogen and bone mineral density in postmenopausal women

“…Osteoporosis is a chronic disease involving a decrease in bone mineral density (BMD) and is one of the most prevalent factors contributing to fractures in the elderly [ 1 ]. The likelihood of osteoporosis increases with age [ 2 ], and the risk of osteoporosis increases further for women after menopause with changes in body hormone levels [ 3 ]. Postmenopausal osteoporosis has been acknowledged as a health care challenge, placing a burden on individuals and health care expenditures, and even posing a higher risk of death [ 4 ].…”