Trends in Bone Mineral Density, Osteoporosis, and Osteopenia Among U.S. Adults With Prediabetes, 2005–2014

Abstract

We aimed to evaluate trends in bone mineral density (BMD) and the prevalence of osteoporosis/osteopenia in U.S. adults with prediabetes and normal glucose regulation (NGR) and further investigate the association among prediabetes, osteopenia/osteoporosis, and fracture. RESEARCH DESIGN AND METHODSWe collected and analyzed data from the U.S. National Health and Nutrition Examination Surveys during the period from 2005 to 2014. Femoral neck and lumbar spine BMD data were available for 5,310 adults with prediabetes and 5,162 adults with NGR >40 years old. RESULTSA shift was observed toward a lower BMD and a higher prevalence of osteopenia/ osteoporosis at the femoral neck and lumbar spine in U.S. adults >40 years old with prediabetes since 2005, especially in men <60 and women ‡60 years old. A shift toward a higher prevalence of osteopenia/osteoporosis at the femoral neck was also observed in adults >40 years old with NGR. Moreover, prediabetes was associated with a higher prevalence of hip fracture, although participants with prediabetes had higher BMD and a lower prevalence of osteopenia/osteoporosis at the femoral neck. CONCLUSIONSThere was a declining trend in BMD from 2005 to 2014 in U.S. adults >40 years old with prediabetes and NGR, and this trend was more significant in men <60 years old. Populations with prediabetes may be exposed to relatively higher BMD but a higher prevalence of fracture.Osteoporosis is a common skeletal disease characterized by low bone mass and microarchitectural deterioration of the skeleton, with a consequently increasing rate of bone fragility and predisposition to fracture (1). According to the literature, ;54 million people in the U.S. alone suffer from osteoporosis or low bone mass at the femoral neck and lumbar spine (2). The high prevalence of osteoporosis and the associated fractures poses a major medical burden, emerging as an important public health issue (3).

Identification of circulating sphingosine kinase-related metabolites for prediction of type 2 diabetes

“…To the best of our knowledge, this is the first study showing the association of T2DM incidence with circulating levels of SphK-related sphingolipids in a prospective epidemiologic setting. Early identification of individuals with high risk of incident diabetes is of critical importance, because diabetes and its complications have been fully proven to be preventable [ 37 , 38 ]. Although conventional risk factors, such as FPG, BMI and dyslipidemia, could predict incident diabetes to a certain degree [ 39 ], their prediction accuracy and sensitivity are limited.…”

Altered Secretome of Diabetic Monocytes Could Negatively Influence Fracture Healing—An In Vitro Study

“…T2DM is associated with multiple complications such as altered micro-and macro-vasculature, nephro-and neuropathies, an overall inflammatory state as well as alterations in bone homeostasis. There is evidence that pre-diabetics already have an altered bone quality and an increased fracture risk [2]. Associated diabetic bone diseases rapidly develop, e.g., diabetic foot syndrome or a Charcot-osteoarthropathy, which affects almost 20% of all diabetics within the first 5 years of the disease [3], often (~20%) resulting in an amputation of the affected limb [4].…”

Low serum levels of bone turnover markers are associated with the presence and severity of diabetic retinopathy in patients with type 2 diabetes mellitus

“…[13][14][15][16][17][18] In addition, a recent study has suggested a relatively higher value of BMD but an increased prevalence of fracture in subjects with prediabetes compared to those with normal glucose regulation. 19 Previous studies using high-resolution peripheral quantitative computed tomography (HR-pQCT) have reported an advantageous trabecular bone microarchitecture but an increase in cortical porosity, 20,21 which partially explains that BMD may underestimate the fracture risk in T2DM. Interestingly, another research by Shanbhogue and colleagues using HR-pQCT found that among patients with T2DM only the presence of MVCs is associated with compromised cortical bone compartment, mostly demonstrating a decreased cortical BMD, cortical thickness, and increased cortical porosity and suggesting that cortical bone deteriorations are a feature in diabetic patients with MVCs, but not in all patients with T2DM.…”

“…Growing evidence, including population‐based observational and longitudinal cohort studies, has linked T2DM to osteoporosis and documented that patients with T2DM exhibited bone fragility and a higher fracture incidence than those without diabetes, 8‐12 although normal or even increased bone mineral density (BMD) was described in patients with T2DM 13‐18 . In addition, a recent study has suggested a relatively higher value of BMD but an increased prevalence of fracture in subjects with prediabetes compared to those with normal glucose regulation 19 …”