Elevated BMD observed in women at risk for type 2 diabetes
Postmenopausal, normoglycemic women with a first-degree family history of diabetes have a higher bone mineral density at the lumbar spine and femoral neck when compared with similar women without a family history of the disease, according to findings published in Menopause.
“Increased BMD has been noted not only in individuals with [type 2 diabetes], but also in individuals with impaired glucose tolerance,” Lijuan Yang, MD, of the department of endocrine and metabolic diseases at the First Affiliated Hospital of Wenzhou Medical University in Zhejiang province, China, and colleagues wrote. “Nevertheless, there are no studies reporting BMD in a population of individuals with a first-degree [family history of diabetes]. Bone is influenced in the early phase of diabetes and hyperinsulinemia is the dominant factor. However, the association between insulin resistance and bone mass is not clear.”
Yang and colleagues analyzed data from 892 normoglycemic, postmenopausal women (median age, 55 years), stratified by whether they had a first-degree relative with diabetes (n = 147). Participants underwent BMD measurements via DXA and provided blood samples to assess fasting plasma insulin, glucose and insulin resistance via homeostasis model assessment of insulin resistance (HOMA-IR).
Researchers found that BMD of the lumbar spine and femoral neck were higher among women with a first-degree relative with diabetes vs. women without a first-degree family history of the disease (P < .05 for both). Lumbar spine BMD and femoral neck BMD were positively associated with HOMA-IR (P = .041 and P = .005, respectively).
In multiple stepwise regression analysis, researchers found that having a first-degree family history of diabetes was an independent factor that was positively associated with lumbar spine BMD (P = .001) and femoral neck BMD (P = .021). A first-degree family history of diabetes was also associated with increased BMD, insulin resistance and hyperinsulinemia, the researchers wrote.
“The present study revealed, for the first time, a significant increase in BMD in normoglycemic individuals with a first-degree [family history of diabetes], supporting the concept that the protective effects on the skeleton occur before the onset of glucose metabolism abnormalities,” the researchers wrote. “Based on these clinical associations, we suggest that the elevated BMD in individuals with a first-degree [family history of diabetes] could be attributed to insulin resistance.”
The researchers noted that future studies are needed to examine the changes in BMD with the evolution of the disease from prediabetes to overt diabetes, and that additional work to further characterize the observation of the T-score is warranted. – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.