Association of bone mineral density with prediabetes risk among African-American and European-American adult offspring of parents with type 2 diabetes

Abstract

IntroductionType 2 diabetes mellitus (T2DM) is associated with alterations in bone mineral density (BMD), but association between prediabetes and BMD is unclear.MethodsWe analyzed BMD among the initially normoglycemic participants in the Pathobiology of Prediabetes in a Biracial Cohort (POP-ABC) study in relation to incident prediabetes during 5 years of follow-up.Results and DiscussionA total of 343 participants (193 Black, 150 White) underwent DEXA during Year 1 of POP-ABC and were followed quarterly for 5 years. The mean age was 44.2 ± 10.6 years; BMI was 30.2 ± 7.23 kg/m2. At baseline, the mean BMD was 1.176 ± 0.135 g/cm2 (1.230 ± 0.124 g/cm2 in men vs. 1.154 ± 0.134 g/cm2 in women, P<0.0001; 1.203 ± 0.114 g/cm2 in Black vs. 1.146 ± 0.150 g/cm2 in White participants, P=0.0003). During 5 years of follow-up, 101 participants developed prediabetes and 10 subjects developed T2DM (progressors); 232 were nonprogressors. Progressors to prediabetes had numerically higher baseline BMD and experienced lower 1-year decline in BMD (P<0.0001) compared with nonprogressors. From Kaplan-Meier analysis, the time to 50% prediabetes survival was 2.15 y among participants in the lowest quartile of baseline BMD, longer than those in higher quartiles (1.31 – 1.41 y). Values for BMD correlated inversely with age and adiponectin levels, and positively with BMI. In logistic regression analysis, BMD z score significantly predicted incident prediabetes: more negative BMD z scores were associated with decreased incident prediabetes (odds ratio 0.598 [95% confidence interval 0.407 - 0.877], P=0.0085), after controlling for age, BMI, change in BMI, ethnicity, blood glucose and adiponectin.ConclusionsAmong initially normoglycemic individuals, higher baseline BMD was associated with higher risk of incident prediabetes during 5 years of follow-up.

Association of Bone Mineral Density and Bone Turnover Markers with the Risk of Diabetes: Hong Kong Osteoporosis Study and Mendelian Randomization

“…Fourth, HKOS participants are all Chinese only, the generalizability to other populations is unknown. Nevertheless, similar associations of BMD with prediabetes risk were observed among African‐American and European‐American offspring, [ 28 ] and the MR analysis was conducted using data derived from the European population, both suggesting that such a relationship may also exist in the non‐Chinese population. Fifth, the measurements for glycemic traits and bone turnover markers in HKOS‐B were unavailable and we were unable to examine the prediction of BMD and bone turnover markers on adverse glycemic traits.…”

“…[ 2,27 ] The positive association is in line with a study showing high BMD is associated with higher prediabetic risk and glycemic deterioration. [ 28 ] In the prospective HKOS‐B cohort, we observed that BMD at the femoral neck and total hip but not the lumbar spine was significantly associated with an increased risk of T2DM in the fully adjusted model. This is in agreement with the observation in the cross‐sectional analysis that the association of BMD at the spine with fasting glucose and Hb A1c had a smaller estimate than the BMD at the hip (Table 3).…”