Insulin resistance and skeletal health

Abstract

Purpose of reviewBone fragility is a complication of type 2 diabetes (T2D), and insulin resistance is suspected to contribute to diabetes-related bone deficits. This article provides an overview of emerging clinical research involving insulin resistance and bone health by summarizing recent publications, identifying existing knowledge gaps, and suggesting 'next steps' for this evolving field of research. Recent findingsClinical studies in children and adults report greater bone density in people with increased insulin resistance, but these associations are often attenuated when adjusting for body size. Advancements in bone imaging methods allow for assessment of nuanced characteristics of bone quality and strength that extend beyond standard bone mineral density assessment methods. For example, several recent studies focusing on lumbar spine trabecular bone score, a relatively new measure of trabecular bone quality from dual-energy X-ray absorptiometry, have reported generally consistent inverse associations with insulin resistance. Longitudinal studies using advanced imaging methods capable of evaluating trabecular bone microstructure and strength, such as high-resolution peripheral quantitative computed tomography, are lacking. Studies in younger individuals are sparse, but emerging data suggest that peak bone mass attainment might be threatened by diabetes progression, and increased visceral fat, suppressed muscle-bone unit, advanced glycation endproducts, sedentary lifestyle, and poor diet quality might contribute to diabetes effects on bone. Prospective studies during the transition from adolescence to young adulthood are required.

Deciphering the complex relationship between type 2 diabetes and fracture risk with both genetic and observational evidence

“…The chronic comorbidities of T2D could develop gradually, and could lead to serious damage to the heart, blood vessels, kidneys, eyes, and feet ( Teck, 2022 ). Other organ systems such as skeletal health could also be influenced by T2D ( Lei and Kindler, 2022 ).…”

Type 2 diabetes and fracture risk: deciphering the complex relationship with both genetic and observational evidence

“…The chronic comorbidities of T2D could develop gradually, and could lead to serious damage to heart, blood vessel, kidney, eye and foot(Teck, 2022). Other organ systems such as skeletal health could also be influenced by T2D(Lei and Kindler, 2022).…”

Effects of vitamin D supplementation on glucose and lipid metabolism in patients with type 2 diabetes mellitus and risk factors for insulin resistance

“…Insulin resistance (IR) refers to a condition in which the body becomes less responsive to insulin[ 8 ], leading to an increase in blood glucose level. In response to hyperglycemia, the pancreas tries to compensates by secreting higher amounts of insulin[ 9 ]. However, over time, the pancreas may not be able to produce sufficient insulin to meet the demand, resulting in DM[ 10 ].…”