Masayuki Iki1, Yuki Fujita2, Katsuyasu Kouda2, Akiko Yura2, Takahiro Tachiki2, Junko Tamaki3, Renaud Winzenrieth4, Yuho Sato5, Jong-Seong Moon6, Nozomi Okamoto7, Norio Kurumatani8. 1. Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-higashi, Osaka-Sayama, Osaka 589-8511, Japan. Electronic address: masa@med.kindai.ac.jp. 2. Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-higashi, Osaka-Sayama, Osaka 589-8511, Japan. 3. Department of Hygiene and Public Health, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan. 4. Medimaps, Parc d'activités Kennedy Bâtiment F, 5 Avenue Henri Becquerel, 33700 Mérignac, France. 5. Department of Human Life, Jin-ai University, 3-1-1 Ohdecho, Echizen, Fukui 915-8586, Japan. 6. Department of Nursing, Kio University, 4-2-2 Umami-naka, Koryo-cho, Nara 365-0832, Japan. 7. Department of Epidemiology and Preventive Medicine, Nara Medical University School of Medicine, 840 Shijocho, Kashihara, Nara 634-8521, Japan. 8. Nara Medical University School of Medicine, 840 Shijocho, Kashihara, Nara 634-8521, Japan.
Abstract
PURPOSE: Patients with type 2 diabetes mellitus (T2DM) have an increased fracture risk despite having higher areal bone mineral density (aBMD). This study aimed to clarify the association between glycemic and insulin resistance status and bone microarchitecture, and whether pentosidine and bone turnover markers play any roles in the association. METHODS: A total of 2012 community-dwelling men aged ≥65years completed baseline measurements of spine aBMD, fasting plasma glucose (FPG) and serum insulin, hemoglobin A1c (HbA1c), osteocalcin, type I procollagen N-terminal propeptide, type I collagen C-terminal crosslinking telopeptide, tartrate-resistant acid phosphatase isoenzyme 5b, pentosidine, height and weight and an interview regarding past disease history. Homeostasis model assessment-insulin resistance (HOMA-IR) was also calculated. T2DM was defined as physician-diagnosed middle age or elderly-onset diabetes mellitus, or according to biochemical test results. To evaluate bone microarchitecture, trabecular bone score (TBS) was calculated at the same vertebrae as those used for aBMD measurement. RESULTS: After excluding participants who had a disease history and/or were taking medications affecting bone metabolism, 1683 men (age, 72.9±5.2years) were analyzed. Men with T2DM had significantly higher aBMD compared to those without T2DM. There was no significant difference in TBS. However, FPG, HbA1c and HOMA-IR levels were significantly inversely correlated with TBS after adjusting for age, BMI and aBMD. Multivariate linear regression analyses revealed that glycemic indices (FPG and HbA1c) were significantly associated with increased aBMD and decreased TBS, and that HOMA-IR was associated only with TBS. These associations did not change after further adjusting for bone turnover makers and pentosidine levels. CONCLUSIONS: Hyperglycemia and elevated insulin-resistance were associated with low TBS independently of bone turnover and pentosidine levels.
PURPOSE:Patients with type 2 diabetes mellitus (T2DM) have an increased fracture risk despite having higher areal bone mineral density (aBMD). This study aimed to clarify the association between glycemic and insulin resistance status and bone microarchitecture, and whether pentosidine and bone turnover markers play any roles in the association. METHODS: A total of 2012 community-dwelling men aged ≥65years completed baseline measurements of spine aBMD, fasting plasma glucose (FPG) and serum insulin, hemoglobin A1c (HbA1c), osteocalcin, type I procollagen N-terminal propeptide, type I collagen C-terminal crosslinking telopeptide, tartrate-resistant acid phosphatase isoenzyme 5b, pentosidine, height and weight and an interview regarding past disease history. Homeostasis model assessment-insulin resistance (HOMA-IR) was also calculated. T2DM was defined as physician-diagnosed middle age or elderly-onset diabetes mellitus, or according to biochemical test results. To evaluate bone microarchitecture, trabecular bone score (TBS) was calculated at the same vertebrae as those used for aBMD measurement. RESULTS: After excluding participants who had a disease history and/or were taking medications affecting bone metabolism, 1683 men (age, 72.9±5.2years) were analyzed. Men with T2DM had significantly higher aBMD compared to those without T2DM. There was no significant difference in TBS. However, FPG, HbA1c and HOMA-IR levels were significantly inversely correlated with TBS after adjusting for age, BMI and aBMD. Multivariate linear regression analyses revealed that glycemic indices (FPG and HbA1c) were significantly associated with increased aBMD and decreased TBS, and that HOMA-IR was associated only with TBS. These associations did not change after further adjusting for bone turnover makers and pentosidine levels. CONCLUSIONS:Hyperglycemia and elevated insulin-resistance were associated with low TBS independently of bone turnover and pentosidine levels.
Authors: Nicola Napoli; Caterina Conte; Claudio Pedone; Elsa S Strotmeyer; Kamil E Barbour; Dennis M Black; Elizabeth J Samelson; Ann V Schwartz Journal: J Clin Endocrinol Metab Date: 2019-08-01 Impact factor: 5.958
Authors: Linsey U Gani; Kundan R Saripalli; Karen Fernandes; Suet F Leong; Koh T Tsai; Pei T Tan; Le R Chong; Thomas F J King Journal: PLoS One Date: 2020-11-19 Impact factor: 3.240