Insulin Resistance Is Associated With Smaller Cortical Bone Size in Nondiabetic Men at the Age of Peak Bone Mass

Verroken, Charlotte; Zmierczak, Hans‐Georg; Goemaere, Stefan; Kaufman, Jean‐Marc; Lapauw, Bruno

doi:10.1210/jc.2016-3609

Cited by 23 publications

(9 citation statements)

References 42 publications

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“…[ 8 20 ] Our findings also align with a few studies which showed the association of IR with small bone size at lumbar spine, tibia, or proximal femur. [ 8 18 21 ] In this study, mean difference of cortical volume was evident, in accordance with the notion from previous studies that type 2 diabetes was associated with cortical bone size deficit. [ 7 22 ] In line with a previous study using DXA data, we observed that QCT-derived bone strength indices of femur neck was significantly lower in women with higher HOMA-IR level, independent of age, body weight, height, and other potential covariates.…”

Section: Discussionsupporting

confidence: 92%

“…[ 23 24 25 ] Altered adipokine secretion pattern, elevated inflammatory cytokine, and reduced 25(OH)D status might contribute to poor bone geometry, all of which are associated with excess body fat and IR. [ 21 ] Mechanical strain generated by muscle also plays important role in determining bone geometry. [ 26 27 ] Muscle function and size are known to be negatively associated with IR, even in nondiabetic subjects.…”

Section: Discussionmentioning

confidence: 99%

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Association of Insulin Resistance with Lower Bone Volume and Strength Index of the Proximal Femur in Nondiabetic Postmenopausal Women

et al. 2018

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BackgroundType 2 diabetes mellitus is associated with an increased risk of osteoporotic fracture despite relatively preserved bone mineral density (BMD). Although this paradox might be attributed to the influence of insulin resistance (IR) on bone structure and material properties, the association of IR with femur bone geometry and strength indices remains unclear.MethodsUsing data from the Cardiovascular and Metabolic Disease Etiology Research Center cohort study, we conducted a cross-sectional analysis among nondiabetic postmenopausal women. IR was estimated using the homeostasis model assessment of IR (HOMA-IR). Compartment-specific volumetric BMD (vBMD) and bone volume of proximal femur were measured using quantitative computed tomography. The compressive strength index (CSI), section modulus (Z), and buckling ratio of the femoral neck were calculated as bone strength indices.ResultsAmong 1,008 subjects (mean age, 57.3 years; body mass index [BMI], 23.6 kg/m2), BMI, waist circumference, and vBMD of the femoral neck and total hip increased in a linear trend from the lowest (<1.37) to highest (≥2.27) HOMA-IR quartile (P<0.05 for all). The HOMA-IR showed an independent negative association with total bone volume (standardized β=−0.12), cortical volume (β=−0.05), CSI (β=−0.013), and Z (β=−0.017; P<0.05 for all) of the femoral neck after adjustment for age, weight, height, physical activity, and vitamin D and high-sensitivity C-reactive protein levels. However, the association between HOMA-IR and vBMD was attenuated in the adjusted model (femoral neck, β=0.94; P=0.548).ConclusionsElevated HOMA-IR was associated with lower cortical bone volume and bone strength indices in nondiabetic postmenopausal women, independent of age and body size.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Association of Insulin Resistance with Lower Bone Volume and Strength Index of the Proximal Femur in Nondiabetic Postmenopausal Women

et al. 2018

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“…Insulin resistance measured using HOMA-IR has been shown to be inversely associated with bone size [ 14 ], potentially explained by high levels of insulin being inversely associated with sex hormone-binding globulin (SHBG), thus increasing the free concentrations of androgens and estrogens [ 32 ]. However, insulin resistance was associated with smaller bone size independent of sex steroid levels in younger adults (mean age 34.5 years) [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Type 2 Diabetes in Relation to Hip Bone Density, Area, and Bone Turnover in Swedish Men and Women: A Cross-Sectional Study

et al. 2018

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Men and women with type 2 diabetes mellitus (T2DM) have higher risk of hip fracture, but the mechanisms are not fully understood. We aimed to investigate how T2DM, glucose, and insulin were associated with femoral bone mineral density (BMD), bone mineral area (BMA), and bone turnover markers. We used two cross-sectional cohorts: the Uppsala Longitudinal Study of Adult Men (ULSAM, n = 452, mean age 82 years) and the Swedish Mammography Cohort Clinical (SMCC, n = 4713, mean age 68 years). We identified men and women with normal fasting glucose (NFG), impaired fasting plasma glucose (IFG), and T2DM. BMD and BMA at the total hip and femoral shaft were measured using dual energy X-ray absorptiometry (DXA). Bone turnover markers; CrossLaps and osteocalcin were measured in women. Linear regression models were applied. Men and women showed a progressively higher BMD following the clinical cutoffs of fasting glucose from NFG to IFG to T2DM. In contrast, there was a progressively lower BMA. Men and women with T2DM, compared to those with NFG, had lower BMA at the total hip (− 1.7%; 95% CI − 3.2, − 0.2 and − 1.0%; 95% CI − 1.6, − 0.4) and the femoral shaft (− 2.0%; 95% CI − 3.5, − 0.4 and − 0.6%; 95% CI − 1.2, − 0.01), respectively. T2DM was associated with lower concentrations of CrossLaps (− 8.1%; 95% CI − 12.7, − 3.6) and osteocalcin (− 15.2%; 95% CI − 19.0, − 11.2). These cross-sectional results indicate that those with T2DM have smaller bone area and lower bone turnover, which could increase the risk of hip fracture.Electronic supplementary materialThe online version of this article (10.1007/s00223-018-0446-9) contains supplementary material, which is available to authorized users.

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“…AGEs can also interfere with osteoblast (40, 41) and osteoclast functions (42), and may also impair osteocyte response (43, 44). AGEs may therefore play an important role in both bone material properties and bone turnover in T2DM (45, 46, 47).…”

Section: Structural and Materials Properties Of Bone In T2dmmentioning

confidence: 99%

Update on the impact of type 2 diabetes mellitus on bone metabolism and material properties

Picke

Campbell

Napoli

et al. 2019

Endocrine Connections

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The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide, especially as a result of our aging society, high caloric intake and sedentary lifestyle. Besides the well-known complications of T2DM on the cardiovascular system, the eyes, kidneys and nerves, bone strength is also impaired in diabetic patients. Patients with T2DM have a 40–70% increased risk for fractures, despite having a normal to increased bone mineral density, suggesting that other factors besides bone quantity must account for increased bone fragility. This review summarizes the current knowledge on the complex effects of T2DM on bone including effects on bone cells, bone material properties and other endocrine systems that subsequently affect bone, discusses the effects of T2DM medications on bone and concludes with a model identifying factors that may contribute to poor bone quality and increased bone fragility in T2DM.

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Insulin Resistance Is Associated With Smaller Cortical Bone Size in Nondiabetic Men at the Age of Peak Bone Mass

Cited by 23 publications

References 42 publications

Association of Insulin Resistance with Lower Bone Volume and Strength Index of the Proximal Femur in Nondiabetic Postmenopausal Women

Association of Insulin Resistance with Lower Bone Volume and Strength Index of the Proximal Femur in Nondiabetic Postmenopausal Women

Type 2 Diabetes in Relation to Hip Bone Density, Area, and Bone Turnover in Swedish Men and Women: A Cross-Sectional Study

Update on the impact of type 2 diabetes mellitus on bone metabolism and material properties

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