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Pubertal increment in insulin resistance is negatively related to lumbar bone mineral density in 18-year-old males

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Abstract

Summary

Transient insulin resistance seen during puberty is expected to favour body growth, but our results show that increment in insulin resistance even in physiological ranges during puberty might compromise lumbar spine bone mineral density accrual independently of body composition parameters, and therefore adult bone quality might be challenged.

Introduction

Insulin resistance (IR) might have a compromising effect on growing bone, and therefore adult bone quality might be challenged. The aim of the present study was to identify whether increases in IR during puberty contribute to bone mineral characteristics in males independently of body composition parameters.

Methods

This is a retrospective cohort-based longitudinal observational study. Data from 85 subjects were included. Boys were studied annually during their pubertal years (12 years at baseline) and at follow-up at the age of 18 years. Anthropometry, bone age, fasting blood samples, body composition, total body, and lumbar spine bone mineral characteristics were measured. Insulin resistance was determined by homeostatic model assessment of IR (HOMA-IR). Multiple regression analysis was performed to determine the effect of changes in HOMA-IR during pubertal years as a longitudinal predictor to fixed bone mineral outcome variables at the age of 18 years. All models were adjusted to potential clinically justified confounding variables.

Results

After adjustment to baseline bone indices and body composition-related predictors, the pubertal increment in the HOMA-IR was a negative independent predictor of lumbar spine bone mineral areal density (β =  − 0.202, p = 0.005) and lumbar spine bone mineral apparent density (β =  − 0.235, p = 0.005) in 18-year-old males.

Conclusions

Pubertal increment in IR has a potential diminishing effect on lumbar spine bone mineral density accrual independently of body composition parameters. Further studies are needed to clarify whether monitoring HOMA-IR during puberty may identify subjects at increased risk of low peak bone mass and possible osteoporosis in the future.

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Funding

This study was funded by the Estonian Research Council grant (PRG 1120 and PRG 1428).

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Authors and Affiliations

  1. Institute of Clinical Medicine, University of Tartu, 51007, Tartu, Estonia

    Eva Mengel, Reeli Tamme & Vallo Tillmann

  2. Tartu Health Care College, 50411, Tartu, Estonia

    Eva Mengel

  3. Children’s Clinic of Tartu University Hospital, 50406, Tartu, Estonia

    Reeli Tamme & Vallo Tillmann

  4. Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007, Tartu, Estonia

    Liina Remmel, Priit Purge, Evelin Mäestu & Jaak Jürimäe

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  1. Eva Mengel
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Correspondence to Eva Mengel.

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Mengel, E., Tamme, R., Remmel, L. et al. Pubertal increment in insulin resistance is negatively related to lumbar bone mineral density in 18-year-old males. Osteoporos Int 34, 161–170 (2023). https://doi.org/10.1007/s00198-022-06591-9

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