High Body Mass Index and Triglycerides Help Protect against Osteoporosis in Patients with Type 2 Diabetes Mellitus

Zhao, Hang; Zheng, Chong; Gan, Kexin; Qi, Cuijuan; Ren, Luping; Song, Guangyao

doi:10.1155/2020/1517879

Cited by 10 publications

(7 citation statements)

References 33 publications

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“…Total osteocalcin levels . Total osteocalcin levels were reported in 29 studies [ 21 , 53 , 60 , 62 – 65 , 68 , 74 , 76 , 77 , 80 , 81 , 84 , 92 , 97 , 105 , 107 , 119 , 126 , 129 , 135 , 144 , 146 , 147 , 151 , 153 , 166 , 175 ], including 6,332 participants. Obesity was not associated with any difference in osteocalcin levels between individuals with and without obesity ( S7 Fig ), except in studies combining men and women (n = 9: MD = -3.86 ng/ml, 95% CI: -6.78, -0.95, P = 0.009, I 2 = 97%).…”

Section: Resultsmentioning

confidence: 99%

Association between obesity and risk of fracture, bone mineral density and bone quality in adults: A systematic review and meta-analysis

et al. 2021

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Background The association between obesity and fracture risk may be skeletal site- and sex-specific but results among studies are inconsistent. Whilst several studies reported higher bone mineral density (BMD) in patients with obesity, altered bone quality could be a major determinant of bone fragility in this population. Objectives This systematic review and meta-analysis aimed to compare, in men, premenopausal women and postmenopausal women with obesity vs. individuals without obesity: 1) the incidence of fractures overall and by site; 2) BMD; and 3) bone quality parameters (circulating bone turnover markers and bone microarchitecture and strength by advanced imaging techniques). Data sources PubMed (MEDLINE), EMBASE, Cochrane Library and Web of Science were searched from inception of databases until the 13th of January 2021. Data synthesis Each outcome was stratified by sex and menopausal status in women. The meta-analysis was performed using a random-effect model with inverse-variance method. The risks of hip and wrist fracture were reduced by 25% (n = 8: RR = 0.75, 95% CI: 0.62, 0.91, P = 0.003, I2 = 95%) and 15% (n = 2 studies: RR = 0.85, 95% CI: 0.81, 0.88), respectively, while ankle fracture risk was increased by 60% (n = 2 studies: RR = 1.60, 95% CI: 1.52, 1.68) in postmenopausal women with obesity compared with those without obesity. In men with obesity, hip fracture risk was decreased by 41% (n = 5 studies: RR = 0.59, 95% CI: 0.44, 0.79). Obesity was associated with increased BMD, better bone microarchitecture and strength, and generally lower or unchanged circulating bone resorption, formation and osteocyte markers. However, heterogeneity among studies was high for most outcomes, and overall quality of evidence was very low to low for all outcomes. Conclusions This meta-analysis highlights areas for future research including the need for site-specific fracture studies, especially in men and premenopausal women, and studies comparing bone microarchitecture between individuals with and without obesity. Systematic review registration number CRD42020159189

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Section: Resultsmentioning

confidence: 99%

Association between obesity and risk of fracture, bone mineral density and bone quality in adults: A systematic review and meta-analysis

et al. 2021

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“…Our previous study showed that a high BMI and TG levels protected against osteoporosis, and these patients tended to have higher vitamin D levels. 8 Additionally, with extension of the course of DM, pancreatic function showed a downward trend, from the state of IR to the stage of insulin secretion disorder. Regression analysis showed that 25OHD and the IR index were not associated when we adjusted for no or some confounding factors.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Status is Independently Associated with Insulin Resistance in Patients with Type 2 Diabetes Mellitus

Zhao¹,

Tang²,

Zheng

et al. 2021

RMHP

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Purpose This study aimed to examine whether 25-hydroxyvitamin D (25OHD) levels (an indicator of vitamin D status) are independently associated with insulin resistance (IR) in patients with type 2 diabetes mellitus (T2DM). Patients and Methods This was a cross-sectional study. Participants with T2DM were recruited from the Department of Endocrinology in Hebei General Hospital according to inclusion and exclusion criteria. Data on basic characteristics and blood parameters were collected. We used the IR index (20/[fasting C-peptide × fasting plasma glucose]) to evaluate IR. Potential confounding factors were selected from comparisons among different IR index groups of quartiles and were adjusted in different models. Results We included 172 subjects (121 men and 51 women) whose mean age was 53.2±10.6 years. Body mass index (BMI), DM course, insulin use, glycated hemoglobin (HbA1c), fasting blood glucose, fasting C-peptide, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (ApoA1), and albumin were differed among different IR-index groups (all P value <0.05). In models 1 and 2, no or some confounding factors were adjusted for, and we found that there was no relationship between 25OHD and the IR index. In model 3, when all confounding factors (DM course, insulin use, BMI, HbA1c, TG, HDL-C, ApoA1, albumin and other bone turnover markers) were adjusted for, the IR index was increased by 5.6% when 25OHD levels increased by 1 ng/mL (odds ratio: 1.056; 95% confidence interval: 1.009, 1.105). Conclusion Vitamin D is independently associated with IR in patients with T2DM.

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“…Both T2DM and osteoporosis are chronic disorders which are associated with severe morbidity and increased mortality. 4 Although there are a few previous studies which reported increased BMI declines the risk of osteoporosis in patients with diabetes mellitus, 5 , 6 it seems that available evidence on the association between obesity indices and bone mineral density (BMD) or risks of osteoporosis was controversial. A lot of previous studies showed a positive correlation between BMI and BMD, 6 while several other studies suggested that obesity was a risk factor for certain fractures.…”

Section: Introductionmentioning

confidence: 99%

Associations of Obesity Indices with Bone Mineral Densities and Risk of Osteoporosis Stratified Across Diabetic Vascular Disease in T2DM Patients

Zheng¹,

Zhou²,

Wang³

et al. 2022

DMSO

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To evaluate associations of obesity indices with bone mineral densities (BMD) and risk of osteoporosis in T2DM patients totally and stratified across presence of any diabetic cardiovascular complications. Methods: Cross-sectional analyses of baseline information on a cohort of 250 T2DM patients were conducted in Xiamen, China. Obesity indices included body weight, height, body mass index (BMI), waist and waist hip ratio (WHR). BMD was measured using dual-energy X-ray absorptiometry at three different sites, and osteoporosis was defined based on the minimum T-scores of BMD. Presence of any diabetic vascular complications was confirmed by checking their medical records histories. Results: Among the 250 T2DM patients, 50 (20.0%) were defined as osteoporosis. Multivariable linear regression and multivariable logistic regression analyses showed that igher obesity indices, including body weight, BMI and waist, but neither body height nor waist hip ratio, were positively associated with the minimum T-scores of BMD and had significantly decreased risk of osteoporosis. Stratified analyses across presence of any of diabetic vascular complications showed similar results for those with any of diabetic vascular complications, while no significant association between obesity indices and minimum T-scores of BMD was found for those without. Postmenopausal women (vs men) and ever drinking were significantly associated with increased risk of osteoporosis, and the adjusted odds ratios (95% CIs) were 5.165 (1.762-15.138, p = 0.003) and 3.789 (1.087-13.214, p = 0.037), respectively. None of metabolic profiles, including systolic and diastolic blood pressure, triglyceride, total cholesterol, high-density lipoprotein cholesterol, HbA1c and blood uric acid, was significantly associated with either minimum T-scores of BMD or risk of osteoporosis. Conclusion: Associations of obesity indices with either BMD or risk of osteoporosis in T2DM patients varied by presence of any diabetic vascular complication and should be not interpreted as causal without considering the often-unmeasured effect modification by health status.

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High Body Mass Index and Triglycerides Help Protect against Osteoporosis in Patients with Type 2 Diabetes Mellitus

Cited by 10 publications

References 33 publications

Association between obesity and risk of fracture, bone mineral density and bone quality in adults: A systematic review and meta-analysis

Association between obesity and risk of fracture, bone mineral density and bone quality in adults: A systematic review and meta-analysis

Vitamin D Status is Independently Associated with Insulin Resistance in Patients with Type 2 Diabetes Mellitus

Associations of Obesity Indices with Bone Mineral Densities and Risk of Osteoporosis Stratified Across Diabetic Vascular Disease in T2DM Patients

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