HemoglobinA1c Is a Risk Factor for Changes of Bone Mineral Density: A Mendelian Randomization Study

Ji, Xiaoxiao; Hong, Jianqiao; Qu, Zihao; Yang, Weinan; Wang, Yibo; Lin, Jiyan; Li, Congsun; Wang, Jie; Mou, Haochen; Shi, Mude; Zhou, Chenhe; Wang, Wei; Lin, Changjian; Yan, Shigui; Wu, Haobo

doi:10.3389/fendo.2022.942878

Cited by 9 publications

(4 citation statements)

References 41 publications

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“…In a previous study, similar to diabetics, high prediabetics have lower trabecular bone score (TBS) than normoglycemic individuals [ 32 ]. And another study revealed the significant causal effect of HbA1c on BMD [ 33 ]. In insulin resistant states, insulin signaling leads to expansion of bone marrow adipose tissue and decreased trabecular BMD [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Development and internal validation of a clinical prediction model for osteopenia in Chinese middle-aged and elderly men: a prospective cohort study

Li,

Zeng,

Pan

et al. 2024

BMC Musculoskelet Disord

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Background Early identification of patients at risk of osteopenia is an essential step in reducing the population at risk for fractures. We aimed to develop and validate a prediction model for osteopenia in Chinese middle-aged and elderly men that provides individualized risk estimates. Methods In this prospective cohort study, 1109 patients who attend regular physical examinations in the Second Medical Centre of Chinese PLA General Hospital were enrolled from 2015.03 to 2015.09. The baseline risk factors included dietary habits, exercise habits, medical histories and medication records. Osteopenia during follow-up were collected from Electronic Health Records (EHRs) and telephone interviews. Internal validation was conducted using bootstrapping to correct the optimism. The independent sample T-test analysis, Mann_Whitney U test, Chi-Square Test and multivariable Cox regression analysis were utilized to identify predictive factors for osteopenia in Chinese middle-aged and elderly men. A nomogram based on the seven variables was built for clinical use. Concordance index (C-index), receiver operating characteristic curve (ROC), decision curve analysis (DCA) and calibration curve were used to evaluate the efficiency of the nomogram. Results The risk factors included in the prediction model were bone mineral density at left femoral neck (LNBMD), hemoglobin (Hb), serum albumin (ALB), postprandial blood glucose (PBG), fatty liver disease (FLD), smoking and tea consumption. The C-index for the risk nomogram was 0.773 in the prediction model, which presented good refinement. The AUC of the risk nomogram at different time points ranged from 0.785 to 0.817, exhibiting good predictive ability and performance. In addition, the DCA showed that the nomogram had a good clinical application value. The nomogram calibration curve indicated that the prediction model was consistent. Conclusions Our study provides a novel nomogram and a web calculator that can effectively predict the 7-year incidence risk of osteopenia in Chinese middle-aged and elderly men. It is convenient for clinicians to prevent fragility fractures in the male population.

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Section: Discussionmentioning

confidence: 99%

Development and internal validation of a clinical prediction model for osteopenia in Chinese middle-aged and elderly men: a prospective cohort study

Li,

Zeng,

Pan

et al. 2024

BMC Musculoskelet Disord

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“…The association between glycaemic control and bone fragility is controversial [ 23 , 24 , 25 ]. It is well known that some antidiabetic drugs affect bone metabolism, increasing fracture risk (sulfonylureas, thiazolidinediones and insulin treatment) [ 26 , 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…For instance, the association between glycaemic control and bone fragility is controversial. Poor glycaemic control has been associated with lower bone mineralization in most studies [ 23 , 24 ], but not in others [ 25 ]. It is known that some antidiabetic drugs affect bone metabolism.…”

Section: Introductionmentioning

confidence: 99%

Reduced High-Density Lipoprotein Cholesterol Is an Independent Determinant of Altered Bone Quality in Women with Type 2 Diabetes

Dule

Barchetta

Cimini

et al. 2023

IJMS

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Type 2 diabetes mellitus (T2DM) is associated with an increased fracture risk. Our study aimed to explore differences in bone alterations between T2DM women and controls and to assess clinical predictors of bone impairment in T2DM. For this observational case control study, we recruited 126 T2DM female patients and 117 non-diabetic, age- and BMI-comparable women, who underwent clinical examination, routine biochemistry and dual-energy X-ray absorptiometry (DXA) scans for bone mineral density (BMD) and trabecular bone score (TBS) assessment-derived indexes. These were correlated to metabolic parameters, such as glycemic control and lipid profile, by bivariate analyses, and significant variables were entered in multivariate adjusted models to detect independent determinants of altered bone status in diabetes. The T2DM patients were less represented in the normal bone category compared with controls (5% vs. 12%; p = 0.04); T2DM was associated with low TBS (OR: 2.47, C.I. 95%: 1.19–5.16, p = 0.016) in a regression model adjusted for age, menopausal status and BMI. In women with T2DM, TBS directly correlated with plasma high-density lipoprotein cholesterol (HDL-c) (p = 0.029) and vitamin D (p = 0.017) levels. An inverse association was observed with menopausal status (p < 0.001), metabolic syndrome (p = 0.014), BMI (p = 0.005), and waist circumference (p < 0.001). In the multivariate regression analysis, lower HDL-c represented the main predictor of altered bone quality in T2DM, regardless of age, menopausal status, BMI, waist circumference, statin treatment, physical activity, and vitamin D (p = 0.029; R2 = 0.47), which likely underlies common pathways between metabolic disease and bone health in diabetes.

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“…[38] In addition, Mendelian Randomization Pleiotropy Residual Sum and Outlier (MR-PRESSO) was performed to detect and correct for horizontal pleiotropy through removing outliers. [39] MR-PRESSO outlier test is based on the InSIDE assumption and requires that at least half of the IVs to be valid and has balanced pleiotropy. [40] Heterogeneity assessment of individual genetic variants was performed by Cochran Q statistic.…”

Section: Discussionmentioning

confidence: 99%

Causal effects of circulating vitamin levels on the risk of heart failure: a Mendelian randomization study

Guan¹,

CHEN²,

Liu³

et al. 2023

Journal of Geriatric Cardiology

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BACKGROUND Observational studies suggest inverse associations between serum vitamin levels and the risk of heart failure (HF). However, the causal effects of vitamins on HF have not been fully elucidated. Here, we conducted a Mendelian randomization (MR) study to investigate the causal associations between genetically determined vitamin levels and HF.METHODS Genetic instrumental variables for circulating vitamin levels, including vitamins A, B, C, D, and E, which were assessed as either absolute or metabolite levels were obtained from public genome-wide association studies. Summary statistics for single-nucleotide-polymorphisms and HF associations were retrieved from the HERMES Consortium (47,309 cases and 930,014 controls) and FinnGen Study (30,098 cases and 229,612 controls). Two-sample MR analyses were implemented to assess the causality between vitamin levels and HF per outcome database, and the results were subsequently combined by meta-analysis. RESULTSOur MR study did not find significant associations between genetically determined circulating vitamin levels and HF risk. For absolute vitamin levels, the odds ratio for HF ranged from 0.97 (95% confidence interval [CI]: 0.85-1.09, P = 0.41) for vitamin C to 1.05 (95% CI: 0.61-1.82, P = 0.85) for vitamin A. For vitamin metabolites, the odds ratio ranged between 0.94 (95% CI: 0.75-1.19, P = 0.62) for α-tocopherol and 1.11 (95% CI: 0.98-1.26, P = 0.09) for γ-tocopherol.CONCLUSION Evidence from our study does not support the causal effects of circulating vitamin levels on HF. Therefore, there may be no direct beneficial effects of vitamin intake on the prevention of primary HF.

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HemoglobinA1c Is a Risk Factor for Changes of Bone Mineral Density: A Mendelian Randomization Study

Cited by 9 publications

References 41 publications

Development and internal validation of a clinical prediction model for osteopenia in Chinese middle-aged and elderly men: a prospective cohort study

Development and internal validation of a clinical prediction model for osteopenia in Chinese middle-aged and elderly men: a prospective cohort study

Reduced High-Density Lipoprotein Cholesterol Is an Independent Determinant of Altered Bone Quality in Women with Type 2 Diabetes

Causal effects of circulating vitamin levels on the risk of heart failure: a Mendelian randomization study

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