Association of serum prealbumin with risk of osteoporosis in older adults with type 2 diabetes mellitus: a cross-sectional study

Abstract

Background: Poor nutritional status is associated with osteoporosis. Prealbumin is a more sensitive marker than albumin to assess nutritional status. Therefore, the relationship between serum levels of prealbumin and osteoporosis in older adults with type 2 diabetes mellitus (T2DM) was investigated. Methods: A total of 370 older adults with T2DM were divided into two groups: older adults with osteoporosis ( n = 249) and older adults without osteoporosis ( n = 121). Bone mineral density (BMD) and appendicular skeletal muscle (ASM) were measured by dual-energy X-ray absorptiometry (DEXA). Serum levels of prealbumin, highly sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), 25-hydroxyvitamin D 3 [25(OH) D 3 ] were also tested. Logistic regression analysis was performed to assess the association between prealbumin and osteoporosis. Results: The adults with osteoporosis had lower prealbumin levels than those without osteoporosis (235.40 ± 60.66 versus 261.34 ± 55.28 mg/l, p < 0.001). The proportion of adults with prealbumin levels below the normal range was significantly higher in individuals with osteoporosis compared with those without osteoporosis (16.53% versus 4.42%, respectively). After adjusting for age, sex, body mass index (BMI), anemia, handgrip strength and skeletal muscle index (SMI), logistic regression showed that participants with lower levels of prealbumin had a higher risk of osteoporosis [odds ratio (OR): 3.85; 95% confidence interval (CI): 1.54–6.34; p = 0.004]. Conclusion: Our findings suggested that low levels of prealbumin were associated with an increased risk of osteoporosis in older adults with T2DM. Further longitudinal studies should be conducted to determine if there is a causative association between prealbumin and osteoporosis.

Hemoglobin level and osteoporosis in Chinese elders with type 2 diabetes mellitus

“…The participants were consecutively recruited by Xuanwu Hospital from July 2016 to May 2018. Detailed information on the assessment of related factors for osteoporosis was reported in our previous study [ 9 ]. The Research Ethics Boards at Xuanwu Hospital approved this study (approval number: CTR-IPR-2019002).…”

“…The BMD (g/cm 2 ) for the lumbar spine (L 2 -L 4 ), right femoral neck and total hip were determined by DEXA (LUNAR iDXA, USA) using methods that had been previously reported [ 9 ]. According to the criteria recommended by the WHO in 1994, participants with a T-score ≤ −2.5 SD at any of the lumbar spine, femoral neck and hip sites were classified as osteoporosis [ 22 ].…”

“…Fasting blood glucose (FBG), creatinine (CRE), fasting insulin (FINS), and fasting C peptide (FCP) were determined by using an automatic biochemical analyzer (BioTek Instrument, Inc., Beijing, China). Hemoglobin A1c (HbA1c), 25-hydroxyvitamin D 3 [25(OH)D 3 ], interleukin (IL) − 6 and high-sensitivity C-reactive protein (hs-CRP) were measured as previously described [ 9 ]. The insulin resistance (IR) index (HOMA-IR) was calculated as FINS (μIU/mL) × FBG (mmol/L)/22.5.…”

“…Previous studies demonstrated that osteoporosis was related with aging, a low body mass index (BMI), physical inactivity, low vitamin D levels [ 1 ], increased proinflammatory cytokine [ 8 ], and poor nutritional status [ 9 ]. In addition, several studies reported that anemia was related with a higher risk of osteoporosis and fracture [ 10 , 11 ] Anemia often occurs in older people.…”

Transthyretin: From Structural Stability to Osteoarticular and Cardiovascular Diseases

“…In women with osteoporosis and in older adults with type 2 diabetes mellitus (T2DM), the plasma level of TTR was specifically associated with low bone mineral density [ 135 , 136 ]. Inverse correlation between the levels of TTR and inflammation markers (hs-CRP) suggests a protective role of TTR in osteoporosis [ 135 ].…”