Department of Education, Taichung Veterans General Hospital, Taichung, Taiwan.
Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
Front Endocrinol (Lausanne). 2022 Sep 20;13:971960. doi: 10.3389/fendo.2022.971960. eCollection 2022.
We investigated the associations of insulin resistance and β-cell secretion with bone mineral density (BMD) and osteoporosis using data from the National Health and Nutrition Examination Survey. Data on BMD assessed using dual-energy x-ray absorptiometry from 5292 participants were analyzed. Insulin resistance and β-cell secretion were assessed using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and β-cell function (HOMA-β), respectively. We divided the study population into four groups according to HOMA-IR (<2 vs. ≥ 2) and HOMA-β (<100 vs. ≥ 100). BMD and T score at the lumbar spine, hip joint, and femur were used for analyses. Osteoporosis was defined as a T score ≤ -2.5. Logistic regression analyses were conducted to examine the associations of HOMA-IR and HOMA-β with osteoporosis, and the joint effects of HOMA-IR and HOMA-β on osteoporosis. We found a positive association between HOMA-IR and osteoporosis in participants with a HOMA-β ≥ 100 (OR 8.773, 95% CI 2.160-35.637, p=0.002 at the femoral neck). A negative association between HOMA-β and osteoporosis was noted in those with a HOMA-IR <2 (OR 0.183, 95% CI 0.038-0.882, p=0.034 at the femoral neck). Compared with participants who had HOMA-IR <2 and HOMA-β <100, those with HOMA-IR <2 and HOMA-β ≥ 100 had a lower risk of osteoporosis (OR 0.126, 95% CI 0.020-0.805, p=0.032 at the femoral neck). In conclusion, the association between HOMA-β and BMD/osteoporosis changed as HOMA-IR increased. HOMA-β was negatively associated with osteoporosis when HOMA-IR <2. The association was not significant when HOMA-IR ≥ 2.
我们利用来自全国健康与营养调查的数据，研究了胰岛素抵抗和β细胞分泌与骨密度（BMD）和骨质疏松症的关联。分析了 5292 名参与者使用双能 X 射线吸收法评估的 BMD 数据。分别使用稳态模型评估的胰岛素抵抗（HOMA-IR）和β细胞功能（HOMA-β）来评估胰岛素抵抗和β细胞分泌。我们根据 HOMA-IR（<2 与≥2）和 HOMA-β（<100 与≥100）将研究人群分为四组。使用腰椎、髋关节和股骨的 BMD 和 T 评分进行分析。骨质疏松症定义为 T 评分≤-2.5。进行逻辑回归分析以检查 HOMA-IR 和 HOMA-β 与骨质疏松症的关联，以及 HOMA-IR 和 HOMA-β 对骨质疏松症的联合影响。我们发现 HOMA-IR 与 HOMA-β≥100 的参与者的骨质疏松症之间存在正相关（OR 8.773，95%CI 2.160-35.637，p=0.002 于股骨颈）。在 HOMA-IR<2 的人群中，HOMA-β 与骨质疏松症之间存在负相关（OR 0.183，95%CI 0.038-0.882，p=0.034 于股骨颈）。与 HOMA-IR<2 和 HOMA-β<100 的参与者相比，HOMA-IR<2 和 HOMA-β≥100 的参与者骨质疏松症的风险较低（OR 0.126，95%CI 0.020-0.805，p=0.032 于股骨颈）。总之，随着 HOMA-IR 的增加，HOMA-β 与 BMD/骨质疏松症之间的关联发生了变化。当 HOMA-IR<2 时，HOMA-β 与骨质疏松症呈负相关。当 HOMA-IR≥2 时，相关性不显著。
