Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN, United States.
Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, United States.
Front Endocrinol (Lausanne). 2023 Jan 5;13:1065527. doi: 10.3389/fendo.2022.1065527. eCollection 2022.
Type 2 diabetes mellitus (T2DM) is associated with alterations in bone mineral density (BMD), but association between prediabetes and BMD is unclear.
We analyzed BMD among the initially normoglycemic participants in the Pathobiology of Prediabetes in a Biracial Cohort (POP-ABC) study in relation to incident prediabetes during 5 years of follow-up.
A total of 343 participants (193 Black, 150 White) underwent DEXA during Year 1 of POP-ABC and were followed quarterly for 5 years. The mean age was 44.2 ± 10.6 years; BMI was 30.2 ± 7.23 kg/m. At baseline, the mean BMD was 1.176 ± 0.135 g/cm (1.230 ± 0.124 g/cm in men vs. 1.154 ± 0.134 g/cm in women, P<0.0001; 1.203 ± 0.114 g/cm in Black vs. 1.146 ± 0.150 g/cm in White participants, P=0.0003). During 5 years of follow-up, 101 participants developed prediabetes and 10 subjects developed T2DM (progressors); 232 were nonprogressors. Progressors to prediabetes had numerically higher baseline BMD and experienced lower 1-year decline in BMD (P<0.0001) compared with nonprogressors. From Kaplan-Meier analysis, the time to 50% prediabetes survival was 2.15 y among participants in the lowest quartile of baseline BMD, longer than those in higher quartiles (1.31 - 1.41 y). Values for BMD correlated inversely with age and adiponectin levels, and positively with BMI. In logistic regression analysis, BMD z score significantly predicted incident prediabetes: more negative BMD z scores were associated with decreased incident prediabetes (odds ratio 0.598 [95% confidence interval 0.407 - 0.877], P=0.0085), after controlling for age, BMI, change in BMI, ethnicity, blood glucose and adiponectin.
Among initially normoglycemic individuals, higher baseline BMD was associated with higher risk of incident prediabetes during 5 years of follow-up.
2 型糖尿病（T2DM）与骨密度（BMD）改变有关，但前驱糖尿病与 BMD 的关系尚不清楚。
我们分析了在为期 5 年的随访中，最初血糖正常的参与者在 Biracial 队列中的前驱糖尿病的病理生理学（POP-ABC）研究中，与 incident 性前驱糖尿病相关的 BMD。
共有 343 名参与者（193 名黑人，150 名白人）在 POP-ABC 的第 1 年接受了 DEXA 检查，并在接下来的 5 年内每季度进行随访。平均年龄为 44.2 ± 10.6 岁；BMI 为 30.2 ± 7.23 kg/m。基线时，平均 BMD 为 1.176 ± 0.135 g/cm（男性为 1.230 ± 0.124 g/cm，女性为 1.154 ± 0.134 g/cm，P<0.0001；黑人参与者为 1.203 ± 0.114 g/cm，白人参与者为 1.146 ± 0.150 g/cm，P=0.0003）。在 5 年的随访中，有 101 名参与者发展为前驱糖尿病，10 名参与者发展为 T2DM（进展者）；232 名是非进展者。与非进展者相比，进展为前驱糖尿病的患者在基线 BMD 较高，且在第 1 年 BMD 下降幅度较低（P<0.0001）。从 Kaplan-Meier 分析来看，在基线 BMD 最低四分位数的参与者中，达到 50%前驱糖尿病生存的时间为 2.15 年，长于较高四分位数（1.31-1.41 年）。BMD 值与年龄和脂联素水平呈负相关，与 BMI 呈正相关。在逻辑回归分析中，BMD z 评分显著预测前驱糖尿病的发生：更负的 BMD z 评分与前驱糖尿病的发生风险降低相关（比值比 0.598 [95%置信区间 0.407 - 0.877]，P=0.0085），在校正年龄、BMI、BMI 变化、种族、血糖和脂联素后。
在最初血糖正常的个体中，较高的基线 BMD 与 5 年内发生前驱糖尿病的风险增加相关。
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