Division of Endocrinology & Metabolism, The Johns Hopkins Hospital, Baltimore, MD, USA.
J Clin Densitom. 2011 Jul-Sep;14(3):332-9. doi: 10.1016/j.jocd.2011.04.007. Epub 2011 Jun 11.
Persons with type 2 diabetes mellitus (T2DM) are at increased risk for hip fracture despite normal bone mineral density (BMD). The contribution of body composition to hip geometry, a measure of hip strength, has not been studied in T2DM. We hypothesized that lean mass would predict hip geometry. Subjects (n=134) for this cross-sectional analysis were men and women aged 56 ± 6yr with non-insulin-requiring T2DM. Fat and lean mass were measured with dual-energy X-ray absorptiometry (DXA). Abdominal fat was measured with magnetic resonance imaging. Hip geometry parameters including section modulus, cross-sectional area, and buckling ratio were estimated from DXA using validated formulae. Subjects had normal BMD, elevated body mass indices (29-41 kg/m(2)), and controlled T2DM (hemoglobin A1c: 5.1-8.3%). In bivariate analysis, lean mass was positively associated with section modulus and cross-sectional area in both sexes (r=0.36-0.55, p<0.05). In multivariate analyses, lean mass remained a significant predictor of all hip strength estimates in both sexes. In women alone, fat mass predicted parameters of hip strength. These data demonstrate that lean mass is significantly associated with hip strength in subjects with non-insulin-requiring T2DM. Resistance exercises that build lean mass may be an intervention for hip fracture prevention in T2DM, although additional research is needed.
2 型糖尿病（T2DM）患者尽管骨密度正常，但髋部骨折风险增加。身体成分对髋部几何形状（衡量髋部强度的指标）的影响在 T2DM 中尚未得到研究。我们假设瘦体重会预测髋部几何形状。本横断面分析的受试者为年龄 56±6 岁、无需胰岛素治疗的 T2DM 男性和女性。使用双能 X 射线吸收法（DXA）测量脂肪和瘦体重。使用磁共振成像测量腹部脂肪。使用 DXA 并通过验证公式从髋部估计髋部几何形状参数，包括截面模数、截面面积和屈曲比。受试者的骨密度正常，体重指数（29-41kg/m2）升高，且 T2DM 得到控制（糖化血红蛋白：5.1-8.3%）。在双变量分析中，瘦体重与两性的截面模数和截面面积均呈正相关（r=0.36-0.55，p<0.05）。在多变量分析中，瘦体重仍然是两性所有髋部强度估计的重要预测因素。仅在女性中，脂肪量预测了髋部强度的参数。这些数据表明，瘦体重与无需胰岛素治疗的 T2DM 患者的髋部强度显著相关。增加瘦体重的抗阻运动可能是 T2DM 预防髋部骨折的一种干预措施，但仍需要进一步的研究。
