Association of Plasma Sex-Related Hormones Levels with Bone Mineral Densities and Risk of Osteoporosis and Osteopenia in Men and Menopausal Women with Type 2 Diabetes Mellitus

Abstract

Objective This study aimed to examine associations between plasma sex-related hormones with bone mineral density (BMD) and risks of osteoporosis or osteopenia in men and postmenopausal women patients with type 2 diabetes mellitus (T2DM). Methods Baseline information on an ongoing cohort of 149 men and 102 postmenopausal women with T2DM in Xiamen, China were analyzed. Plasma estradiol (E2), total testosterone (T), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and prolactin (PRL) were measured. BMD of lumbar spine (L2-4), femoral neck (FN) and total hip (TH) were determined by dual-energy X-ray absorptiometry (DXA). Osteoporosis or osteopenia was defined as the minimum T-scores of BMD of these three different sites of −1.0 or below. Results T2DM patients with osteoporosis/osteopenia (66.4% in men and 79.4% in postmenopausal women), compared to those without, showed significantly decreased level of E2 (75.3±28.9 vs. 107.8±25.9pmol/L and 18.4 (18.4–29.5) vs. 22.8 (18.4–40.5) pmol/L for men and postmenopausal women, respectively, both p-values <0.05), but not other sex-related hormones (including T, FSH, LH, or PRL). For all T2DM patients together and men separately, multivariable linear regression and logistic regression analyses showed that higher E2 levels were significantly associated with higher BMD T-scores in L2-4, FN, TH and minimum of these three different sites, lower 10-year probability of major osteoporotic fractures (MOF) and hip fractures (HFs) estimated by Fracture Risk Assessment Tool score, as well as decreased risk of osteoporosis/osteopenia. As for postmenopausal women T2DM patients, E2 level was positively associated with BMD T-scores in L2-4 and minimum of three different sites but was not independently associated with risk of osteoporosis/osteopenia. Conclusion Higher plasma E2 was significantly associated with increased BMD and lower risk of osteoporosis or osteopenia in T2DM patients, especially for men. Screening of BMD and estradiol levels as well as evaluating risks of osteoporosis/osteopenia are important for T2DM patients.

Associations of sex-related and thyroid-related hormones with risk of metabolic dysfunction-associated fatty liver disease in T2DM patients

“…Patient selection, diagnosis T2DM and clinical measurements have been previously described [14,15]. Briefly, 490 T2DM patients hospitalized in the Department of Endocrinology, Zhongshan Hospital (Xiamen), Fudan University (Xiamen, China) between January 2018 and April 2020 were recruited into the present ongoing T2DM cohort.…”

Associations of metabolic dysfunction-associated fatty liver disease and hepatic fibrosis with bone mineral density and risk of osteopenia/osteoporosis in T2DM patients

“…This study was a cross-sectional analysis of baseline data of our ongoing T2DM cohort. Patient selection, diagnosis, and clinical measurements have been described previously ( 21 , 22 ). Briefly, from January 2018 to April 2020, 490 T2DM patients had been recruited from the Department of Endocrinology, Zhongshan Hospital (Xiamen), Fudan University (Xiamen, China).…”

“…The inclusion criteria were as follows: (1) T2DM, (2) age ≥ 18 years, and (3) BMD testing and hepatic ultrasonography scanning measurements. The exclusion criteria were as follows: other types of diabetes (type 1 diabetes mellitus and secondary diabetes); severe liver and renal dysfunction; receiving or currently receiving estrogen and progesterone drugs, glucocorticoids, and calcium tablets; menopause by surgical intervention or at an unnatural age; familial fragility fracture; or unwillingness to participate in the study ( 21 , 22 ). This study was approved by the Human Research Ethics Committee of the Zhongshan Hospital (Xiamen), Fudan University (Xiamen, China) (B2019-015).…”

“…Each patient received a face-to-face interview to collect sociodemographic data, lifestyle habits, present and previous health history, and medication utilization. Measurements of body weight, height, BMI (weight in kilograms divided by the square of the height in meters), waist circumference (WC), and arterial blood pressure (BP) were conducted as described previously ( 21 , 22 ). Blood samples were collected in the morning after at least 12-h overnight fasting to measure fasting plasma glucose (FPG), glycosylated hemoglobin A1c (HbA1c), liver function, and lipid profiles, and were tested in the clinical laboratory of Zhongshan Hospital (Xiamen), Fudan University (Xiamen, China).…”

Effects of Nutrition Education with Intervention Mapping on Cardiovascular Disease Risk Factors in Women with Borderline Dyslipidemia: Analysis According to Menopausal Status

“…However, it is a main cause of mortality in menopausal women. 1 Hormonal changes caused by menopause produce major physiological changes. Estrogen is a representative female hormone that is essential for female sexual development and growth.…”