Lean Mass Predicts Hip Geometry in Men and Women With Non–Insulin-Requiring Type 2 Diabetes Mellitus

Moseley, Kendall F.; Dobrosielski, Devon A.; Stewart, Kerry J.; Sellmeyer, Deborah E.; Beur, Suzanne M. Jan de

doi:10.1016/j.jocd.2011.04.007

Cited by 17 publications

(15 citation statements)

References 48 publications

(54 reference statements)

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“…In women, however, increasing glucose intolerance was associated with favorable declines in BR, or a decreased propensity to buckle under compression. This outcome has been previously described as a part of WHI-OS in which higher BMI in women was associated with lower BR, as well as in our own work looking at the association between lean mass in T2DM on hip geometry measures [36, 37]. In the Rotterdam Study, men and women with inadequately controlled diabetes had narrower femoral necks and thicker cortices, leading to increased cortical stability and less susceptibility to buckling (decreased BR) when compared to those without diabetes [38].…”

Section: Discussionmentioning

confidence: 71%

Sex-specific differences in progressive glucose intolerance and hip geometry: the Baltimore Longitudinal Study of Aging

et al. 2015

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Summary Fracture risk is increased in type 2 diabetes mellitus (T2DM). The effect of pre-diabetes and T2DM on bone macroarchitecture and strength has not been well investigated. In this study, we show that in women only, both pre-diabetes and T2DM are associated with decreased hip bending strength and mineralization which might lead to skeletal weakness. Introduction Older men and women with T2DM are at increased risk for fracture despite normal bone mineral density (BMD). The discordance between bone quantity and skeletal fragility has driven investigation into additional determinants of fracture resistance in T2DM. Additionally, the effect of pre-diabetes on bone strength has not been well described. The aim of this study was to determine differences in bone macroarchitecture and strength, measured by hip geometry, in persons with normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and T2DM. Methods We performed cross-sectional analyses of older (age >55 years) men (n=472) and women (n=473) participating in the Baltimore Longitudinal Study of Aging (BLSA) classified as NGT, IGT, or T2DM based on oral glucose tolerance testing. Bone strength measures included the hip geometry parameters of section modulus (Z), cross-sectional area (CSA), and buckling ratio (BR). Sex-stratified analyses were conducted using adjusted stepwise regression models. Results In women, IGT and T2DM were negatively associated with hip geometry parameters including mineralization in cross section (CSA, β −0.076 and −0.073, respectively; both p<0.05) and hip bending strength (Z, β −0.097 and −0.09, respectively; both p<0.05); conversely, IGT and T2DM were associated with improved compressive strength (BR, β −0.31 and −0.29, respectively; both p<0.05). There was no significant association between glycemic status and hip geometry in men. Conclusions In women only, both IGT and T2DM were inversely associated with bone macroarchitecture and measures of bone mineralization and bending strength. The same association between worsening glycemic status and bone strength was not observed in men. These data suggest a differential effect of sex on hip geometry with evolving glucose intolerance.

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Section: Discussionmentioning

confidence: 71%

Sex-specific differences in progressive glucose intolerance and hip geometry: the Baltimore Longitudinal Study of Aging

et al. 2015

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“…With manifested type 2 diabetes, LBM might be suitable as a prognostic marker for fracture incidents in a younger population of men and women as well (55). Table 2 Results of random effects meta-analyses of randomized controlled leucine supplementation studies consequence of leucine intervention as well.…”

Section: Effects Of Leucine Supplementation In the Elderlymentioning

confidence: 99%

Effects of leucine-rich protein supplements on anthropometric parameter and muscle strength in the elderly: A systematic review and meta-analysis

Komar

Schwingshackl

Hoffmann

2015

The Journal of nutrition, health and aging

127

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It is concluded that leucine supplementation was found to exert beneficial effects on body weight, body mass index, and lean body mass in older persons in those subjects already prone to sarcopenia, but not muscle strength. However, due to the heterogeneity between the trials included in this systematic review, further studies adopting a homogenous design with respect to participant characteristics duration as well as the kind and amount of daily supplement in use are required.

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“…Men and women with osteoporosis are routinely advised to increase the time they spend performing resistance and weight-bearing exercise to capitalize on the influence of lean mass on osteoblast activity [67]. In T2DM, lean mass is positively associated with both BMD and parameters of hip geometry including buckling ratio and section modulus, surrogate measures of hip strength [68 ▪▪ ,69 ▪▪ ]. Declines in lean mass with progressive insulin resistance, termed ‘sarcopenic obesity’, may, therefore, have immediate implications for bone quality in T2DM [70 ▪▪ ,71].…”

Section: Body Compositionmentioning

confidence: 99%

“…Some investigators have reported significant associations between fat mass and bone density in older men and women [72–75]. In women with noninsulin requiring diabetes mellitus, fat mass is associated with bone density and hip strength [68 ▪▪ ,69 ▪▪ ]. The association was not significant in men.…”

Section: Body Compositionmentioning

confidence: 99%

Type 2 diabetes and bone fractures

Moseley

2012

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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106

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Purpose of review To discuss current literature and hypotheses pertaining to the pathophysiology of increased bone fragility and fracture in men and women with type 2 diabetes mellitus. Recent findings Despite high bone mineral density, studies have shown that men and women with type 2 diabetes mellitus (T2DM) are at increased risk for fracture. Complications of T2DM including retinopathy and autonomic dysfunction may contribute to bone fracture by increasing fall risk. Nephropathy may lead to renal osteodystrophy. Lean mass and potentially fat mass, may additionally contribute to skeletal health in diabetes. There is increasing acknowledgement that the marrow microenvironment is critical to efficient bone remodeling. Medications including thiazolidinediones and selective serotonin reuptake inhibitors may also impair bone remodeling by acting on mesenchymal stem cell differentiation and osteoblastogenesis. T2DM is associated with significant alterations in systemic inflammation, advanced glycation end-product accumulation and reactive oxygen species generation. These systemic changes may also directly and adversely impact the remodeling cycle and lead to bone fragility in T2DM, though more research is needed. Summary Fracture is a devastating event with dismal health consequences. Identifying the extrinsic and intrinsic biochemical causes of bone fracture in T2DM will speed the discovery of effective strategies for fracture prevention and treatment in this at-risk population.

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Lean Mass Predicts Hip Geometry in Men and Women With Non–Insulin-Requiring Type 2 Diabetes Mellitus

Cited by 17 publications

References 48 publications

Sex-specific differences in progressive glucose intolerance and hip geometry: the Baltimore Longitudinal Study of Aging

Sex-specific differences in progressive glucose intolerance and hip geometry: the Baltimore Longitudinal Study of Aging

Effects of leucine-rich protein supplements on anthropometric parameter and muscle strength in the elderly: A systematic review and meta-analysis

Type 2 diabetes and bone fractures

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