Bone Mineral Density is positively associated with risk of All-Cause and Cardiovascular Mortality among Adults with Type 2 Diabetes Mellitus:a cross-sectional study of the NHANES 2005-2010,2013-2014

Abstract

Background With aging and lifestyle changes, the coexistence of osteoporosis and T2DM is becoming more and more common, which greatly improves the disability and mortality of patients.However, the associations of reduced BMD value with CVD and all-cause mortality in patients with T2DM have not been conclusively established. Methods Using the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the U.S. population,we aim to estimate the association of bone mineral density with the risk of CVD mortality and all-cause mortality in US adults with T2DM. Results We demonstrated that increased bone mineral density was significantly positively related to decreased mortality from all causes and cardiovascular diseases among US adults with T2DM.Meanwhile,we found that, after multivariate adjustment, osteoporosis and osteopenia were independently associated with an increased risk of all-cause and CVD mortality in T2DM patients at long-term follow-up.In terms of CVD mortality,stratified analyses suggested that these associations were stronger in participants who had a wider waist and higher total triglyceride,and the relationships in other stratified were mostly consistent with the total T2DM patients.In addition,a variety of sensitivity analyses indicated the robustness of our findings. Conclusions T2DM patients with low BMD value should be aware of the potential risk of cardiovascular disease and mortality, and carry out secondary prevention of osteoporosis and osteopenia as early as possible.