scholarly journals Bone Mass and Density in Youth with Type 2 Diabetes, Obesity, and Healthy Weight

2020 ◽  
Author(s):  
Joseph M. Kindler ◽  
Andrea Kelly ◽  
Philip R. Khoury ◽  
Lorraine E. Levitt Katz ◽  
Elaine M. Urbina ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bone Mass ◽  
Fracture Risk ◽  
Visceral Fat ◽  
Whole Body ◽  
Areal Bone Mineral Density ◽  
Healthy Weight ◽  
Mineral Density ◽  
Z Scores

<b>Objective</b>: Youth-onset type 2 diabetes is an aggressive condition with increasing incidence. Adults with type 2 diabetes have increased fracture risk despite normal areal bone mineral density (aBMD), but the influence of diabetes on the growing skeleton is unknown. We compared bone health in youth with type 2 diabetes to controls with obesity or healthy weight. <p><b>Research Design and Methods</b>: Cross-sectional study of youth (56% African American, 67% female) ages 10-23 years with type 2 diabetes (n=180), obesity (BMI>95<sup>th</sup>; n=226), or healthy weight (BMI<85<sup>th</sup>; n=238). Whole body (less head) aBMD and lean mass, and abdominal visceral fat were assessed via DXA. Lean body mass index (LBMI) and aBMD standard deviation (SD) scores (“Z-scores”) were computed using published reference data. </p> <p><b>Results</b>: We observed age-dependent differences in aBMD and LBMI Z-scores between the healthy weight, obese, and type 2 diabetes groups. In children, aBMD and LBMI Z-scores were greater in the type 2 diabetes vs obese groups, but in adolescents and young adults, aBMD and LBMI Z-scores were lower in the type 2 diabetes vs. obese group (age interactions P<0.05). In the type 2 diabetes and obese groups, aBMD was about 0.5 SDs lower for a given LBMI Z-score compared to healthy weight controls (P<0.05). Further, aBMD was lower in those with greater visceral fat (β=-0.121, P=0.047).</p> <p><b>Conclusions</b>: These results suggest that type 2 diabetes may be detrimental to bone density around the age of peak bone mass. Given the increased fracture risk in adults with type 2 diabetes, there is a pressing need for longitudinal studies aimed at understanding the influence of diabetes on the growing skeleton.</p>

scholarly journals Bone Mass and Density in Youth with Type 2 Diabetes, Obesity, and Healthy Weight

2020 ◽  
Author(s):  
Joseph M. Kindler ◽  
Andrea Kelly ◽  
Philip R. Khoury ◽  
Lorraine E. Levitt Katz ◽  
Elaine M. Urbina ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bone Mass ◽  
Fracture Risk ◽  
Visceral Fat ◽  
Whole Body ◽  
Areal Bone Mineral Density ◽  
Healthy Weight ◽  
Mineral Density ◽  
Z Scores

<b>Objective</b>: Youth-onset type 2 diabetes is an aggressive condition with increasing incidence. Adults with type 2 diabetes have increased fracture risk despite normal areal bone mineral density (aBMD), but the influence of diabetes on the growing skeleton is unknown. We compared bone health in youth with type 2 diabetes to controls with obesity or healthy weight. <p><b>Research Design and Methods</b>: Cross-sectional study of youth (56% African American, 67% female) ages 10-23 years with type 2 diabetes (n=180), obesity (BMI>95<sup>th</sup>; n=226), or healthy weight (BMI<85<sup>th</sup>; n=238). Whole body (less head) aBMD and lean mass, and abdominal visceral fat were assessed via DXA. Lean body mass index (LBMI) and aBMD standard deviation (SD) scores (“Z-scores”) were computed using published reference data. </p> <p><b>Results</b>: We observed age-dependent differences in aBMD and LBMI Z-scores between the healthy weight, obese, and type 2 diabetes groups. In children, aBMD and LBMI Z-scores were greater in the type 2 diabetes vs obese groups, but in adolescents and young adults, aBMD and LBMI Z-scores were lower in the type 2 diabetes vs. obese group (age interactions P<0.05). In the type 2 diabetes and obese groups, aBMD was about 0.5 SDs lower for a given LBMI Z-score compared to healthy weight controls (P<0.05). Further, aBMD was lower in those with greater visceral fat (β=-0.121, P=0.047).</p> <p><b>Conclusions</b>: These results suggest that type 2 diabetes may be detrimental to bone density around the age of peak bone mass. Given the increased fracture risk in adults with type 2 diabetes, there is a pressing need for longitudinal studies aimed at understanding the influence of diabetes on the growing skeleton.</p>

scholarly journals Diet Quality and Bone Density in Youth with Healthy Weight, Obesity, and Type 2 Diabetes

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3288
Author(s):  
Joseph M. Kindler ◽  
Sina Gallo ◽  
Philip R. Khoury ◽  
Elaine M. Urbina ◽  
Babette S. Zemel
Keyword(s):  
Bone Mineral Density ◽  
Type 2 Diabetes ◽  
Diet Quality ◽  
Whole Body ◽  
Areal Bone Mineral Density ◽  
Healthy Weight ◽  
Z Score ◽  
Mineral Density ◽  
Z Scores

Purpose: To assess relationships between diet quality and areal bone mineral density (aBMD) in youth with healthy weight, obesity, and type 2 diabetes (T2D). Methods: We performed a secondary analysis of cross-sectional data from youth (55% African American, 70% female) ages 10–23 years with T2D (n = 90), obesity (BMI > 95th; n = 128), or healthy weight (BMI < 85th; n = 197). Whole body (less head) areal bone mineral density (aBMD) was assessed by dual-energy X-ray absorptiometry (DXA). aBMD was expressed as age-, sex-, and ancestry-specific standard deviation scores (Z-scores). Whole body aBMD Z-scores were adjusted for height-for-age Z-score. Diet was assessed via three-day diaries, and the Healthy Eating Index (HEI) was computed. Total HEI score and HEI subcomponent scores were compared across groups, and associations with aBMD Z-scores were assessed via linear regression adjusted for group, age, sex, and ancestry. Results: Mean HEI was similar between the healthy weight, obesity, and T2D groups. Several HEI sub-components differed between groups, including meats and beans, total vegetables, milk, saturated fat, sodium, oils, and empty calories. The obesity and T2D group had significantly greater aBMD Z-scores compared to the healthy weight group. Multiple linear regression analyses revealed a significant positive association between HEI and aBMD Z-score (p < 0.05). The HEI sub-components for whole grains (p = 0.052) and empty calories (p < 0.05) were positively associated with aBMD Z-score. Conclusions: Individuals that followed a dietary pattern more closely aligned with the Dietary Guidelines for Americans had greater bone density. Since few studies have investigated the role of diet on bone in youth with obesity-related conditions, additional research is required among these populations.

Trabecular Bone Score in Thais with or without Type 2 Diabetes

2020 ◽  
Vol 103 (11) ◽  
pp. 1131-1137
Keyword(s):  
Diabetes Mellitus ◽  
Bone Mineral Density ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Fracture Risk ◽  
Trabecular Bone ◽  
Trabecular Bone Score ◽  
Mineral Density ◽  
Men And Women

Background: When compared to people without type 2 diabetes mellitus (T2DM), people with T2DM have an increase in fracture risk despite having higher bone mineral density (BMD). Many studies in Caucasians demonstrated that trabecular bone score (TBS) is lower in people with T2DM than those without. The utility of TBS as a fracture risk assessment tool in Asians with T2DM is currently unclear. Objective: To compared lumbar spine (LS) BMD and TBS in Thais with or without T2DM and investigate the correlation between TBS and hemoglobin A1c (HbA1c) and diabetes duration in participants with T2DM. Materials and Methods: The present study was a cross-sectional study that included 97 participants with T2DM (37 men and 60 women) and 342 participants without T2DM (174 men and 168 women). LS-BMD and TBS were obtained. Results: Men and women with T2DM were older and had higher body mass index (BMI). Men with T2DM had significant higher LS-BMD (1.051±0.166 versus 0.972±0.125, p=0.009) and non-significant lower TBS (1.333±0.084 versus 1.365±0.096, p=0.055) than those without. Similarly, women with T2DM had significant higher LS-BMD (0.995±0.155 versus 0.949±0.124, p=0.021) and lower TBS (1.292±0.105 versus 1.382±0.096, p<0.001). After adjusting for age and BMI, T2DM predicted higher BMD in men (p<0.001), but not in women (p=0.143). T2DM was not associated with TBS after adjusting for age and BMI in both genders (p=0.403 and p=0.151 in men and women, respectively). TBS did not correlate with HbA1c in both genders. However, TBS was non-significantly associated with diabetes duration in women (p=0.073), but not in men (p=0.639). Conclusion: T2DM significantly predicted higher LS-BMD only in men and was not independently associated with TBS in both genders. These data highlighted that, in T2DM, there was some variation in the clinical usefulness of BMD and TBS in predicting osteoporotic fractures with regard to clinical characteristic of participants. Keywords: Bone mineral density, Type 2 diabetes mellitus, Trabecular bone score

scholarly journals Bone Mass and Density in Youth With Type 2 Diabetes, Obesity, and Healthy Weight

Diabetes Care ◽  
2020 ◽  
Vol 43 (10) ◽  
pp. 2544-2552
Author(s):  
Joseph M. Kindler ◽  
Andrea Kelly ◽  
Philip R. Khoury ◽  
Lorraine E. Levitt Katz ◽  
Elaine M. Urbina ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bone Mass ◽  
Healthy Weight

Exercise without weight loss is an effective strategy for obesity reduction in obese individuals with and without Type 2 diabetes

2005 ◽  
Vol 99 (3) ◽  
pp. 1220-1225 ◽  
Author(s):  
SoJung Lee ◽  
Jennifer L. Kuk ◽  
Lance E. Davidson ◽  
Robert Hudson ◽  
Katherine Kilpatrick ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Skeletal Muscle ◽  
Weight Loss ◽  
Visceral Fat ◽  
Subcutaneous Fat ◽  
Substantial Reduction ◽  
Whole Body ◽  
Moderate Intensity ◽  
Regional Body Composition

It is unclear whether chronic exercise without caloric restriction or weight loss is a useful strategy for obesity reduction in obese men with and without Type 2 diabetes (T2D). We examined the effects of exercise without weight loss on total and regional adiposity and skeletal muscle mass and composition in lean men and in obese men with and without T2D. Twenty-four men participated in 13 wk of supervised aerobic exercise, five times per week for 60 min at a moderate intensity (∼60% peak oxygen uptake). Total and regional body composition was measured by magnetic resonance imaging. Skeletal muscle composition was determined using computed tomography. Cardiorespiratory fitness was assessed using a graded maximal treadmill test. Body weight did not change within any group in response to exercise ( P > 0.1). Significant reductions in total, abdominal subcutaneous, and visceral fat were observed within each group ( P < 0.01). The reduction in total and abdominal subcutaneous fat was not different ( P > 0.1) between groups; however, the reduction in visceral fat was greater ( P < 0.01) in the obese and T2D groups by comparison to the lean group. A significant ( P < 0.01) increase in total skeletal muscle, high-density muscle area, and mean muscle attenuation was observed independent of group, and these changes were not different between groups ( P > 0.1). Accordingly, whole body fat-to-muscle ratio was increased ( P < 0.01) independent of groups. In conclusion, regular exercise without weight loss is associated with a substantial reduction in total and visceral fat and in skeletal muscle lipid in both obesity and T2D.

scholarly journals Testosterone Therapy Effects on Bone Mass and Turnover in Hypogonadal Men with Type 2 Diabetes

2021 ◽  
Author(s):  
Georgia Colleluori ◽  
Lina Aguirre ◽  
Nicola Napoli ◽  
Clifford Qualls ◽  
Dennis T Villareal ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Composition ◽  
Liquid Chromatography ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Quantitative Computed Tomography ◽  
Male Hypogonadism ◽  
Mineral Density ◽  
Testosterone Therapy

Abstract Context Male hypogonadism is associated with low bone mineral density (BMD) and increased fragility fracture risk. Patients with type 2 diabetes (T2D) have relatively higher BMD, but greater fracture risk. Objective Evaluate the skeletal response to testosterone therapy in hypogonadal men with T2D compared to hypogonadal men without T2D. Design, Method And Participants Single arm, open-label clinical (NCT01378299) trial involving 105 men (40-74 years old), with average morning testosterone&lt;300ng/dl. Subjects were injected intramuscularly with testosterone cypionate (200mg) every 2 weeks for 18 months. Testosterone and estradiol assessed by liquid-chromatography/mass-spectroscopy; serum C-telopeptide (CTX), osteocalcin and sclerostin by ELISA; A1C by high performance liquid chromatography, areal BMD (aBMD) and body composition by dual-energy x-ray absorptiometry; tibial volumetric BMD (vBMD) and bone geometry by peripheral quantitative computed tomography. Results Among our population of hypogonadal men, 49 had T2D and 56 were non-T2D. After 18 months of testosterone therapy, there were no differences in circulating testosterone and estradiol between the groups. Hypogonadal men with T2D had increased osteocalcin, reflecting increased osteoblast activity, compared to non-T2D men (p&lt;0.01). T2D men increased lumbar spine aBMD (p&lt;0.05), total area at 38% tibia (p&lt;0.01) and periosteal and endosteal circumferences at the same site (p&lt;0.01 for both). T2D men had reduced tibial vBMD (p&lt;0.01), but with preserved bone mineral content (p=0.01). Changes in A1c or body composition were similar between the 2 groups. Conclusions Testosterone therapy results in greater improvements in the skeletal health of hypogonadal men with T2D than their non-diabetic counterparts.

scholarly journals Comparison of FRAX in postmenopausal Asian women with and without type 2 diabetes mellitus: a retrospective observational study

2019 ◽  
Vol 48 (2) ◽  
pp. 030006051987959
Author(s):  
Chen Wang ◽  
Jun Liu ◽  
Li Xiao ◽  
Dan Liu ◽  
Wenjing Yan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Fracture Risk ◽  
Postmenopausal Women ◽  
World Health ◽  
Asian Women ◽  
Study Cohort ◽  
Mineral Density

Objective To compare the fracture risk in postmenopausal Asian women with or without type 2 diabetes mellitus (T2DM). Methods The study cohort comprised data from consecutive postmenopausal women with T2DM that were retrieved from a prospectively maintained institutional database from 2001 to 2009. Postmenopausal women without DM from the Medical Examination Center from 2001 to 2009 formed the control cohort. The primary endpoint was the World Health Organization Fracture Risk Algorithm (FRAX, revised 2013) score. The secondary endpoint was bone mineral density (BMD). Results There were 1014 individuals included for the assessment (T2DM, n=500 and non-DM, n=514). Based on the FRAX model, the risk of major osteoporotic fractures and hip fractures over the next 10 years was higher in the T2DM group compared with the non-DM group. Compared with the T2DM group, the non-DM group had a lower BMD. After adjusting for age, gender, history of alcohol consumption, smoking status, body mass index, and low-density lipoprotein, the differences were statistically significant. Conclusions Compared with postmenopausal women without DM, postmenopausal women with T2DM had a significantly higher fracture risk calculated using the FRAX model. Early intervention for postmenopausal women with T2DM may be necessary, although T2DM is associated with a high BMD.

scholarly journals The Relationship Between Bone Mineral Density and Type 2 Diabetes in Obese Children and Adolescents at the Time of Initial Diagnosis

2018 ◽  
Vol 51 (01) ◽  
pp. 42-46
Author(s):  
Hae Lee ◽  
Jong Yoon ◽  
Kyu Park ◽  
Jung Lim ◽  
Jin Hwang
Keyword(s):  
Bone Mineral Density ◽  
Type 2 Diabetes ◽  
Lumbar Spine ◽  
Children And Adolescents ◽  
Bone Mineral ◽  
Tanner Stage ◽  
Mineral Density ◽  
Femur Neck ◽  
Z Scores

AbstractLong-term effects of type 2 diabetes mellitus (T2D) on bone health remain unclear. The objective of this study was to assess the possible association of bone mineral density (BMD) at multiple sites with T2D after correcting for several potential confounders such as age, sex, Tanner stage, and BMI known to affect BMD in adolescents with newly developed T2D. In this cross-sectional study, 17 children and adolescents with T2D and 59 age, sex, and BMI-matched controls were included. All subjects underwent dual-energy X-ray absorptiometry to measure regional and whole-body composition with Lunar Prodigy at the time of initial diagnosis. A BMD Z-score was calculated using data from healthy Korean children and adolescents after adjusting for height-for-age. The mean age of all subjects was 12.9±2.4 years (range, 8.3–18.3 years). BMDht Z-scores for lumbar spine and total body after adjusted for age, sex, BMI SDS, and Tanner stage were not significantly different between patients and controls. However, BMDht Z-scores for femur neck and bone mineral apparent density (BMAD) Z-scores of lumbar spine were significantly lower in T2D patients than those in healthy controls. HOMA-IR or HbA1c was not associated with BMDht Z-scores at multiple sites. BMDht Z-scores at multiple sites except femur neck in adolescents with newly developed T2D were similar to those in obese controls after adjustment for potential confounders.

Bone mass and density in youth with type 2 diabetes, obesity, and healthy weight

2021 ◽  
Author(s):  
Kindler JM ◽  
Kelly A ◽  
Khoury PR ◽  
Levitt Katz LE ◽  
Urbina EM ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bone Mass ◽  
Healthy Weight

scholarly journals Type 2 Diabetes Mellitus in Nursing Home Patients: Effects on Bone Turnover, Bone Mass, and Fracture Risk

2006 ◽  
Vol 91 (9) ◽  
pp. 3355-3363 ◽  
Author(s):  
Harald Dobnig ◽  
Jutta Claudia Piswanger-Sölkner ◽  
Martin Roth ◽  
Barbara Obermayer-Pietsch ◽  
Andreas Tiran ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Nursing Home ◽  
Bone Mass ◽  
Bone Turnover ◽  
Fracture Risk ◽  
Nursing Home Patients
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