Associations between components of the metabolic syndrome versus bone mineral density and vertebral fractures in patients with type 2 diabetes

• Published in: Bone (New York, N.Y.) Vol. 45; no. 2; pp. 174 - 179
• Main Authors: Yamaguchi, Toru, Kanazawa, Ippei, Yamamoto, Masahiro, Kurioka, Soichi, Yamauchi, Mika, Yano, Shozo, Sugimoto, Toshitsugu
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Inc 01.08.2009; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Atherosclerosis - complications; Biological and medical sciences; Bone Density - physiology; Bone mineral density; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - physiopathology; Female; Fundamental and applied biological sciences. Psychology; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Metabolic diseases; Metabolic Syndrome - complications; Metabolic Syndrome - physiopathology; Middle Aged; Miscellaneous; Orthopedics; Osteoarticular system. Muscles; Osteoporosis - complications; Other metabolic disorders; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Spinal Fractures - complications; Spinal Fractures - physiopathology; The metabolic syndrome; Type 2 diabetes mellitus; Vertebral fractures; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Visceral fat accumulation; baPWV; Vertebral fractures; odds ratio; T-C; uNTX; Type 2 diabetes mellitus; systolic blood pressure; total cholesterol; Cr; bone mineral density; radial; Trunk fat; urinary C-peptide; urinary N-terminal cross-linked telopeptide of type-I collagen; visceral fat area; DBP; diastolic blood pressure; vertebral fracture; The metabolic syndrome; LBM; cholesterol; femoral neck; subcutaneous fat area; body mass index; DXA; total fat mass; VF; IMT; brachial-ankle pulse wave velocity; osteocalcin; FPG; fasting plasma glucose; triglyceride; lean body mass; C; confidential interval; FN; percent fat mass; L; creatinine; R; total; S; OC; T; V; BMD; BMI; computed tomography; lumbar; SBP; bone specific alkaline phosphatase; OR; CI; trunk fat mass; Visceral fat accumulation; uC-peptide; BAP; CT; intima-media thickness; TG; Fat; dual X-ray absorptiometry; Bone mineral density; Endocrinopathy; Type 2 diabetes; Human; Diseases of the osteoarticular system; Metabolic diseases; Cardiovascular disease; Vertebra; Fracture; Metabolic syndrome; Trauma; Morphology; Comparative study
• ISSN: 8756-3282; 1873-2763
• DOI: 10.1016/j.bone.2009.05.003

Abstract The association of bone with the metabolic syndrome and its features, visceral fat accumulation or insulin resistance, remains unclear. We determined visceral and subcutaneous fat areas (V and S) by computed tomography on 187 men (28–83 years) and 125 postmenopausal women (46–82 years) with type 2 diabetes. Men whose V was 100 cm2 or more had significantly lower urinary N-terminal cross-linked telopeptide of type-I collagen ( p = 0.005), higher femoral neck bone mineral density (FN-BMD) ( p = 0.004), and lower prevalence of vertebral fractures (VFs) ( p = 0.04) than controls. Fat mass, V, S, and lean body mass positively correlated with FN-BMD in men and with lumbar (L) and FN-BMD in women. When adjusted for weight, these correlations became negative. Urinary C-peptide positively correlated with FN-BMD in both genders. Multivariate logistic regression analysis adjusted for age, height, weight, L-BMD, duration of diabetes, and diabetes therapies identified V in men and urinary C-peptide in women as factors inversely associated with the presence of VFs [odds ratio (OR) = 0.61 per SD increase, p = 0.04, and OR = 0.32, p = 0.01, respectively]. These findings suggest that, of the components of the metabolic syndrome, body fat in gravity and hyperinsulinemia could increase FN-BMD in diabetic subjects. Visceral fat in men and hyperinsulinemia in women may protect against VFs independent of weight, L-BMD, diabetes duration, or therapies.