Liao Cheng-Yen, Hsieh Ai-Ru, He Ya-Min, Chen Hua-Chun, Kao Chung-Lan
Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, 11221, Taiwan.
Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Arch Osteoporos. 2025 Jul 16;20(1):98. doi: 10.1007/s11657-025-01580-x.
This retrospective analysis of 11,595 individuals aged ≥ 50 years from the Taiwan Biobank demonstrated that prediabetes and type 2 diabetes mellitus (T2DM) were associated with higher bone mineral density (BMD). Prolonged T2DM duration correlated with increased lumbar spine BMD, while its effect on femoral neck BMD was nonsignificant after adjusting for confounding factors.
The relationship between T2DM, prediabetes and BMD has remained uncertain due to conflicting findings in previous research. This study aims to investigate the association between T2DM, prediabetes and BMD among middle-aged and older adults with Taiwan Biobank database.
The retrospective study included 11,595 patients aged ≥ 50 years from the Taiwan Biobank (2012-2021), comprising 2,476 in the control group, 6,877 in the prediabetes group, and 2,242 in the T2DM group. Categorical variables were analyzed with Pearson's chi-square, and continuous data was obtained using the Mann-Whitney U test. Significant variables (p < 0.05) in the univariate analysis were included in a multivariate logistic regression analysis. Patients with T2DM or prediabetes exhibited higher BMD at all measured sites compared to controls (p < 0.001).
Multivariable analysis demonstrated that both conditions were independently associated with a lower osteoporosis rate. Individuals with T2DM for > 10 years had higher lumbar spine BMD compared to those with T2DM for 5-10 or < 5 years. However, T2DM duration > 10 years was associated with lower BMD at the bilateral femoral necks compared to those with a duration of 5-10 years. After adjusting for confounders, diabetes duration ≥ 10 years was no longer a significant predictor of lower femoral neck BMD. In the normal-weight category, individuals with T2DM had a significantly lower prevalence of osteoporosis than those with prediabetes and controls (p < 0.001). This inverse association was not observed in the underweight, overweight, or obese groups.
Prediabetes and T2DM are correlated with higher BMD in middle-aged and older adults. A longer T2DM duration is associated with increased BMD at the lumbar spine but not the femoral neck after adjusting for confounders.
对台湾生物银行11595名年龄≥50岁的个体进行的这项回顾性分析表明，糖尿病前期和2型糖尿病（T2DM）与较高的骨密度（BMD）相关。T2DM病程延长与腰椎骨密度增加相关，而在调整混杂因素后，其对股骨颈骨密度的影响不显著。
由于先前研究结果相互矛盾，T2DM、糖尿病前期与骨密度之间的关系仍不确定。本研究旨在利用台湾生物银行数据库调查中老年人群中T2DM、糖尿病前期与骨密度之间的关联。
这项回顾性研究纳入了台湾生物银行（2012 - 2021年）的11595名年龄≥50岁的患者，包括对照组2476人、糖尿病前期组6877人、T2DM组2242人。分类变量采用Pearson卡方检验分析，连续数据采用Mann-Whitney U检验获得。单因素分析中有统计学意义的变量（p < 0.05）纳入多因素逻辑回归分析。与对照组相比，T2DM或糖尿病前期患者在所有测量部位的骨密度均较高（p < 0.001）。
多因素分析表明，这两种情况均与较低的骨质疏松症发生率独立相关。T2DM病程>10年的个体与病程为5 - 10年或<5年的个体相比，腰椎骨密度更高。然而，与病程为5 - 10年的个体相比，T2DM病程>10年的个体双侧股骨颈骨密度较低。调整混杂因素后，糖尿病病程≥10年不再是股骨颈骨密度降低的显著预测因素。在正常体重类别中，T2DM患者的骨质疏松症患病率显著低于糖尿病前期患者和对照组（p < 0.001）。在体重过轻、超重或肥胖组中未观察到这种负相关。
糖尿病前期和T2DM与中老年人群较高的骨密度相关。调整混杂因素后，较长病程的T2DM与腰椎骨密度增加相关，但与股骨颈骨密度无关。
