Abstract
Summary
This study was undertaken to assess the effect of blood glucose on BMD and interactions with age, sex, and BMI in a Taiwanese population. Both obese and non-obese people with type 2 diabetes (T2DM) had higher BMD, at lumbar spine and femoral neck, compared with healthy subjects. In addition, the prevalence of osteoporosis significantly decreased with blood sugar and HbA1c.
Purpose
This study was undertaken to assess the effect of blood glucose on BMD and possible interactions with age, sex, and BMI in a Taiwanese population.
Patients and methods
This study was a retrospective cross-sectional study using data from the Health Examination Database of Changhua Christian Hospital. Data on BMD of the lumbar spine and femoral neck were obtained by dual X-ray absorptiometry (DXA), and other relevant clinical and laboratory data were recorded.
Results
The type 2 diabetes (T2DM) group had a higher BMD than the controls. When comparing the prevalence of osteoporosis between subjects by glucose and HbA1c level, the prevalence of osteoporosis significantly decreased with blood glucose and HbA1c. In addition, the BMD of the lumbar spine and femoral neck was higher in the T2DM group than in the controls. Osteoporosis was negatively associated with DM, BMI, and drinking, but positively associated with age, female gender, previous fracture history, and other diseases of the musculoskeletal system and connective tissue. The association between diabetes and osteoporosis remained statistically significant after adjusting for the above factors. T2DM was associated with lower odds of osteoporosis in both obese (OR = 0.77) and non-obese (OR = 0.63) (p for interaction = 0.555).
Conclusions
Both obese and non-obese people with T2DM had higher BMD, at lumbar spine and femoral neck, compared with healthy subjects. In addition, the prevalence of osteoporosis significantly decreased with blood glucose and HbA1c.
Similar content being viewed by others
References
Barrett-Connor E, Holbrook TL (1992) Sex differences in osteoporosis in older adults with non—insulin-dependent diabetes mellitus. JAMA 268:3333–3337
Bonds DE, Larson JC, Schwartz AV, Strotmeyer ES, Robbins J, Rodriguez BL, Johnson KC, Margolis KL (2006) Risk of fracture in women with type 2 diabetes: the Women’s health initiative observational study. J Clin Endocrinol Metab 91:3404–3410
Leslie WD, Lix LM, Prior HJ, Derksen S, Metge C, O'Neil J (2007) Biphasic fracture risk in diabetes: a population-based study. Bone 40:1595–1601
Majima T, Komatsu Y, Yamada T, Koike Y, Shigemoto M, Takagi C, Hatanaka I, Nakao K (2005) Decreased bone mineral density at the distal radius, but not at the lumbar spine or the femoral neck, in Japanese type 2 diabetic patients. Osteoporos Int 16:907–913
PF Shan XPW, Zhang H, Cao XZ, Yuan LQ, Liao EY (2011) Age-related bone mineral density, osteoporosis rate and risk of vertebral fracture in mainland Chinese women with type 2 diabetes mellitus. J Endocrinol Investig 34:190–196
Starup-Linde J, Eriksen SA, Lykkeboe S, Handberg A, Vestergaard P (2014) Biochemical markers of bone turnover in diabetes patients--a meta-analysis, and a methodological study on the effects of glucose on bone markers. Osteoporos Int 25:1697–1708
Yoon KH, Lee JH, Kim JW, Cho JH, Choi YH, Ko SH, Zimmet P, Son HY (2006) Epidemic obesity and type 2 diabetes in Asia. Lancet 368:1681–1688
Zhang W, Shen X, Wan C, Zhao Q, Zhang L, Zhou Q, Deng L (2012) Effects of insulin and insulin-like growth factor 1 on osteoblast proliferation and differentiation: differential Signalling via Akt and Erk. Cell Biochem Funct 30:297–302
Zhou Y, Li Y, Zhang D, Wang J, Yang H (2010) Prevalence and predictors of osteopenia and osteoporosis in postmenopausal Chinese women with type 2 diabetes. Diabetes Res Clin Pract 90:261–269
Acknowledgements
We are grateful to Professor Yu-Jun Chang (Epidemiology and Biostatistics Center) for the statistical consultation. We also thank the diabetic patients and normal controls for their participation.
Author information
Authors and Affiliations
Contributions
K-H Li did the main work of preparing the manuscript. M-L Hung contributed to the data collection. Y-T Liu, Y-W Yang, Y-L Lin, and I-C Lin contributed to the design of the study and drafting of the manuscript. All authors contributed toward data analysis, drafting, and critically revising the paper and agree to be accountable for all aspects of the work.
Corresponding author
Ethics declarations
Conflicts of interest
None.
Rights and permissions
About this article
Cite this article
Li, KH., Liu, YT., Yang, YW. et al. A positive correlation between blood glucose level and bone mineral density in Taiwan. Arch Osteoporos 13, 78 (2018). https://doi.org/10.1007/s11657-018-0494-9
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s11657-018-0494-9