Bone Mineral in Pre- and Postmenopausal Women with Insulin-Dependent and Non-insulin-Dependent Diabetes Mellitus

Abstract

The aim of the study was to compare bone mineral density (BMD) and bone turnover in pre- and postmenopausal women with insulin-dependent diabetes mellitus (IDDM), non-insulin-dependent diabetes mellitus (NIDDM) and normal reference women. In a cross-sectional study 31 and 11 premenopausal and 22 and 21 postmenopausal IDDM and NIDDM patients, respectively, were recruited from an outpatient clinic. BMD in the forearm, spine, femur and total body and biochemical markers of bone turnover were measured and compared with reference values obtained from measurements of normal healthy pre- and postmenopausal women. Postmenopausally, but not premenopausally, IDDM patients had lower BMD values than NIDDM patients. Postmenopausal NIDDM patients had higher BMD value than normal women. The differences in BMD between IDDM and NIDDM patients could be explained statistically by differences in body weight between the NIDMM (obese) and IDDM (lean) women. Markers of bone turnover were significantly higher postmenopausally than premenopausally in both IDDM and NIDDM patients. Osteocalcin was significantly lower in postmenopausal NIDDM compared with postmenopausal IDDM patients and reference values. Otherwise there were no differences in the markers of bone turnover between NIDDM and IDDM patients. In conclusion, postmenopausal IDDM patients have a relatively decreased BMD, whereas NIDDM patients seem to be relatively protected from postmenopausal bone loss.

Associations between the metabolic syndrome and bone health in older men and women: the Rancho Bernardo Study

“…However, the association of type 2 diabetes or insulin resistance with bone health is less consistent. Some investigators found higher BMD in the presence of type 2 diabetes (24,26), whereas others reported an inverse association (27). In previous publications from the Rancho Bernardo Study, hyperinsulinemia was positively associated with higher BMD in women, but not men (13), and women with type 2 diabetes or hyperglycemia had higher BMD than women with normal glucose tolerance independent of body weight and other risk factors: bone density did not differ by glycemic status in men (28).…”

MANAGEMENT OF ENDOCRINE DISEASE: Morbidity in polycystic ovary syndrome

“…Hyperandrogenemia, increased androgen sensitivity, adiposity and hyperinsulinemia in PCOS could be associated with higher bone mineral density and protect against the development of osteoporosis (77,78,79,80,81), whereas amenorrhea, increased risk of T2D, low growth hormone levels and increased cortisol may be associated with lower bone mineral density (82). Furthermore, vitamin D levels were lower in patients with PCOS and hirsutism versus controls (83, 84) and 31-85% patients with PCOS had vitamin D levels <50 nmol/L (85), which could be associated with defects in bone mineralization, increased bone turnover and increased fracture risk (81).…”

Diabetes Is Associated Independently of Body Composition With BMD and Bone Volume in Older White and Black Men and Women: The Health, Aging, and Body Composition Study

“…(5,8,9) Higher BMD in those with type 2 diabetes may be due in part to greater obesity associated with the disease. (10,11) Specific components of body weight, that is, lean or fat mass, have not been considered previously and may account for BMD differences among those with and without diabetes. Other possible mechanisms for the relationship between type 2 diabetes and BMD include greater androgenicity, (1) hyperinsulinemia, (10,(12)(13)(14)(15) poor glycemic control, (14,16,17) or an effect on parathyroid function and bone metabolism.…”