2011
DOI: 10.1002/jbmr.1467
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The association between insulin levels and cortical bone: Findings from a cross-sectional analysis of pQCT parameters in adolescents

Abstract: Recent studies suggest that patients with type 2 diabetes mellitus are at increased risk of fracture, possibly because hyperinsulinemia is a risk factor for low bone mineral density, which may in turn be a consequence of a lipotoxic effect of visceral and/or intramuscular fat on bone. In the current study, we investigated whether insulin plays a role in cortical bone development by performing a cross-sectional study based on the Avon Longitudinal Study of Parents and Children (ALSPAC), where we examined associ… Show more

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Cited by 38 publications
(35 citation statements)
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“…Greater visceral adiposity was also accompanied by higher values of insulin resistance, which may have in turn influenced bone metabolism [34, 35]. That the obesity-related trabecular bone deficits were consistently attenuated following adjustment for HOMA-IR supports an intermediary role of insulin resistance in the fat-bone connection [36]. However, the manner in which insulin resistance influences skeletal tissue is relatively uncertain.…”
Section: Discussionmentioning
confidence: 99%
“…Greater visceral adiposity was also accompanied by higher values of insulin resistance, which may have in turn influenced bone metabolism [34, 35]. That the obesity-related trabecular bone deficits were consistently attenuated following adjustment for HOMA-IR supports an intermediary role of insulin resistance in the fat-bone connection [36]. However, the manner in which insulin resistance influences skeletal tissue is relatively uncertain.…”
Section: Discussionmentioning
confidence: 99%
“…Inverse associations of HOMA-IR with periosteal and endosteal circumferences at the ultradistal radius and tibia have been reported in nondiabetic postmenopausal women (14), whereas fasting insulin levels were inversely associated with midtibial periosteal circumference and SSI in adolescents (13), and with midtibial total and cortical bone area and SSI in older adult men (22). Our findings are moreover largely in agreement with the existing literature on bone geometry in T2DM, with 2 pQCT studies reporting a smaller bone area at the distal and midshaft radius and tibia in individuals with vs without T2DM (5, 6).…”
Section: Discussionmentioning
confidence: 99%
“…Alternatively, decreased bone strength may develop early as a consequence of the pathophysiology underlying T2DM, which is characterized by insulin resistance. Indeed, an inverse association of fasting insulin levels with periosteal circumference at the tibia has been reported in healthy adolescents (13), whereas insulin resistance [expressed as the homeostasis model assessment of insulin resistance (HOMA-IR)] correlated inversely with periosteal and endosteal circumference but positively with cortical thickness and trabecular microarchitecture at the ultradistal radius and tibia in nondiabetic postmenopausal women (14). Until now, our understanding of the mechanisms underlying these findings remains limited, and no studies have investigated this in adult men.…”
mentioning
confidence: 99%
“…Sayers et al [44] suggested that the negative relationship between insulin resistance and cortical bone may be, at least in part, attributed to muscle fat. Although Janz et al [45 & ] showed that the relationships between muscle function and cortical bone outcomes were mediated by muscle size, it has also been shown in older and younger adults that muscle adiposity may impede muscular function [46,47].…”
Section: Cortical Bmcmentioning
confidence: 98%
“…Muscle adipose tissue infiltration is associated with metabolic disturbances, such as insulin resistance, which may adversely influence cortical bone geometry in adolescents [43,44]. Sayers et al [44] suggested that the negative relationship between insulin resistance and cortical bone may be, at least in part, attributed to muscle fat.…”
Section: Cortical Bmcmentioning
confidence: 98%