Association of T2DM、Serum Glucose、HbA1c With Lumbar Spine Bone Mineral Density in 40-59 years adults: A Cross Sectional Study Based on the 2011-2018 NHANES Database

Abstract

Backgrounds:Our purpose is to discuss the relationship among the status and duration of T2DM, serum glucose, glycosylated hemoglobin(HbA1c), and lumbar spine bone mineral density (LSBMD).Methods:We selected participants whose age was 40-59 in the NHANES of 2011-2018 for a cross-sectional study. We used the multiple linear regression model to evaluate the status and duration of T2DM, serum glucose, HbA1c, and LSBMD had a linear correlation. We used the smooth curve fitting and threshold effect methods to explore the potential curvilinear relationship and inflection point, further analyzed the subgroups stratified by genders and race and completed the curve fitting.Result:Finally, 5,329 people met the standard. Finally, we found that the positively correlation between the status of T2DM and the LSBMD, however, the duration of T2DM was not associated with the LSBMD.We further used the smooth curve fitting method to explore. And then we found that blood glucose and level of HbA1c had a curvilinear relationship with the BMD of the lumbar spine in the model. The curve was U-shaped. After the saturation effect and threshold effect analysis, the inflection point was 7.77mmol/L and 5.4%, respectively. According to the further subgroup analysis, we found that the blood glucose and HbA1c of male non-Hispanic whites were positively correlated to the BMD of the lumbar spine. However, in female non-Hispanic black people and Mexican Americans, they had the relationship of a U-shaped curve with the BMD of the lumbar spine.Conclusion:The BMD of the lumbar spine of middle-aged people suffering from T2DM was significantly higher than those who do not suffer from diabetes. However, the duration of T2DM was not associated with the LSBMD.Generally speaking, blood glucose and level of HbA1c had a curvilinear relationship with the BMD of the lumbar spine. The curve was U-shaped (The inflection point was 7.77mmol/L and 5.4%, respectively). The blood glucose and HbA1c of male non-Hispanic whites were positively correlated to the BMD of the lumbar spine. However, in the female non-Hispanic black people and Mexican Americans, they had the relationship of a U-shaped curve with the BMD of the lumbar spine.