Department of Internal Medicine, Ribeirão Preto Medical School, USP, 3900 Bandeirantes Avenue, Ribeirao Preto, SP, 14049-900, Brazil.
Department of Physics, Faculty of Philosophy, Sciences, and Letters of Ribeirão Preto, USP, 3900 Bandeirantes Avenue, Ribeirao Preto, SP, 14040-901, Brazil.
Osteoporos Int. 2020 Jun;31(6):1125-1133. doi: 10.1007/s00198-020-05365-5. Epub 2020 Feb 27.
The present study suggests that insulin resistance has no association with bone quantity, but quality.
The literature has contradictory results concerning the influence of insulin resistance on bone. The present study sought to evaluate the association of insulin resistance and adipose tissue with either bone mineral density or the trabecular bone score.
The study included 56 individuals (36 women and 20 men): age = 46.6 ± 14.2 years, weight = 67.8 ± 10.9 kg, height = 1.65 ± 0.10 m and BMI = 24.8 ± 3.9 kg/m. The investigational protocol included biochemical determinations and bone assessment by dual X-ray absorptiometry for evaluation of bone mineral density and trabecular bone score. Magnetic resonance was employed to estimate visceral, subcutaneous and bone marrow adipose tissues, as well as intrahepatic lipids.
The bone mineral density of the lumbar spine, femoral neck and total hip were not associated with insulin resistance-related parameters [visceral adipose tissue, intrahepatic lipids and homeostatic model assessment of insulin resistance (HOMA-IR)]. In contrast, there was a negative relationship between the trabecular bone score and all these components. The association between the trabecular bone score and HOMA-IR was reinforced after adjustment for age and BMI. Marrow adipose tissue was negatively associated with both bone mineral density and trabecular bone score.
The present study shows that the trabecular bone score is negatively associated with marrow adipose tissue, insulin resistance, visceral adipose tissue and intrahepatic lipid measurements. Additionally, there was a negative relationship between saturated lipids in marrow adipose tissue and the trabecular bone score. These results encourage further studies to investigate the role of the trabecular bone score exam in the clinical evaluation of osteoporosis in conditions of insulin resistance.
本研究旨在探讨胰岛素抵抗与骨量之间的关系。
本研究共纳入 56 名研究对象（36 名女性和 20 名男性），年龄为 46.6±14.2 岁，体重为 67.8±10.9kg，身高为 1.65±0.10m，BMI 为 24.8±3.9kg/m2。研究方案包括生化指标检测和双能 X 线吸收法骨密度测定，以评估骨密度和小梁骨评分。采用磁共振成像（MRI）评估内脏脂肪、皮下脂肪和骨髓脂肪组织以及肝内脂肪含量。
腰椎、股骨颈和全髋骨密度与胰岛素抵抗相关参数（内脏脂肪组织、肝内脂肪和稳态模型评估的胰岛素抵抗指数）无相关性。然而，小梁骨评分与所有这些参数呈负相关。在校正年龄和 BMI 后，小梁骨评分与 HOMA-IR 之间的相关性增强。骨髓脂肪组织与骨密度和小梁骨评分均呈负相关。
本研究表明，小梁骨评分与骨髓脂肪组织、胰岛素抵抗、内脏脂肪组织和肝内脂肪含量呈负相关。此外，骨髓脂肪组织中的饱和脂肪与小梁骨评分之间也存在负相关关系。这些结果鼓励进一步研究，以探讨在胰岛素抵抗情况下，小梁骨评分检查在骨质疏松临床评估中的作用。
