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Assessment using serum insulin-like growth factor-I and bone mineral density is useful for detecting prevalent vertebral fractures in patients with type 2 diabetes mellitus

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Abstract

Summary

Bone mineral density (BMD) is less useful for evaluating fracture risk in type 2 diabetes. This study showed for the first time that combined evaluation by serum insulin-like growth factor-I and BMD is useful to assess the risk of vertebral fracture in postmenopausal women and men with type 2 diabetes.

Introduction

BMD is less useful for evaluating fracture risk in type 2 diabetes mellitus (T2DM). We aimed to examine the usefulness of combined evaluation by BMD and serum insulin-like growth factor-I (IGF-I) to assess the risk of vertebral fracture (VF) in T2DM.

Methods

In this cross-sectional study, 412 postmenopausal women and 582 men with T2DM, whose BMD, bone turnover markers, and serum IGF-I were measured, were enrolled. The association of BMD alone, serum IGF-I alone, and combined assessment by BMD and IGF-I with the presence of VF was examined.

Results

Multiple logistic regression analyses showed that IGF-I as well as BMD T-score at lumbar (L) and femoral neck (FN) were significantly associated with VF except for IGF-I in men, respectively. Receiver operating characteristic curves showed that the cutoff values of IGF-I, L T-score and FN T-score were 127 ng/mL, − 1.78, and − 2.02 in postmenopausal women and 127 ng/mL, − 1.67, and − 1.24 in men. Based on the cutoff vales, the subjects were divided into four categories. The category of lower IGF-I and lower T-scores had a significant increased risk of VF compared to higher IGF-I and higher T-scores both in postmenopausal women and in men. The sensitivity and specificity of the combined assessment to detect VF were better compared to using BMD alone or IGF-I alone.

Conclusions

This is the first study to show that in addition to BMD measurement, the assessment using serum IGF-I is useful to estimate the prevalence of VF in patients with T2DM.

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Funding

This study was partly supported by research grant from Eli Lilly Japan.

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Authors and Affiliations

  1. Department of Internal Medicine 1, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, 693-8501, Japan

    I. Kanazawa, M. Notsu, H. Miyake, K. Tanaka & T. Sugimoto

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  1. I. Kanazawa
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  2. M. Notsu
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  3. H. Miyake
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  4. K. Tanaka
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  5. T. Sugimoto
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Correspondence to I. Kanazawa.

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ESM 3

Association between the prevalence of VF versus categories classified by serum IGF-I and T scores in patients with T2DM. Odds ratio of VF in the categories classified by serum IGF-I and L-T score (A) or FN-T score (B) in postmenopausal women. L-T score (C) or FN-T score (D) in men. (PPTX 124 kb)

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Kanazawa, I., Notsu, M., Miyake, H. et al. Assessment using serum insulin-like growth factor-I and bone mineral density is useful for detecting prevalent vertebral fractures in patients with type 2 diabetes mellitus. Osteoporos Int 29, 2527–2535 (2018). https://doi.org/10.1007/s00198-018-4638-y

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  • DOI: https://doi.org/10.1007/s00198-018-4638-y

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