TY - JOUR
T1 - Sex-specific differences in progressive glucose intolerance and hip geometry
T2 - the Baltimore Longitudinal Study of Aging
AU - Moseley, K. F.
AU - Chia, C. W.
AU - Simonsick, E. M.
AU - Egan, J. M.
AU - Ferrucci, L.
AU - Sellmeyer, D. E.
N1 - Funding Information:
This research was supported in part by the Intramural Research Program of the National Institutes of Health, National Institute on Aging, and the National Institute of Diabetes and Digestive and Kidney Diseases, K23DK093720. It was also supported by the Legato Research Scholar Awards in Gender-Specific Medicine, Foundation for Gender-Specific Medicine, Inc.
Publisher Copyright:
© 2015, International Osteoporosis Foundation and National Osteoporosis Foundation.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - 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, ß −0.076 and −0.073, respectively; both p < 0.05) and hip bending strength (Z, ß −0.097 and −0.09, respectively; both p < 0.05); conversely, IGT and T2DM were associated with improved compressive strength (BR, ß −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.
AB - 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, ß −0.076 and −0.073, respectively; both p < 0.05) and hip bending strength (Z, ß −0.097 and −0.09, respectively; both p < 0.05); conversely, IGT and T2DM were associated with improved compressive strength (BR, ß −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.
KW - Bone architecture
KW - Bone quality
KW - Hip geometry
KW - Type 2 diabetes
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U2 - 10.1007/s00198-015-3027-z
DO - 10.1007/s00198-015-3027-z
M3 - Article
C2 - 25619633
AN - SCOPUS:84939945272
SN - 0937-941X
VL - 26
SP - 1555
EP - 1562
JO - Osteoporosis International
JF - Osteoporosis International
IS - 5
ER -