Abstract
BackgroundPuberty is a developmental stage of increased insulin resistance that also is a critical period for bone mass accrual. Historically, African Americans (AA) have lesser risk for osteoporotic fractures compared to European Americans (EA). AA also have higher incidence of insulin resistance. The possibility that bone health and insulin secretion or concentrations are linked has not been investigated.AimsWe aimed to examine the associations of bone mineral density (BMD) and bone mineral apparent density (BMAD) with insulin sensitivity and secretion in healthy adolescent girls and healthy female adults and to evaluate ethnic differences in these associations.Study DesignObservational cohort design.Place and Duration of the StudyUniversity of Alabama at Birmingham, between January 2010 and September 2011.MethodologyHealthy, female, non-smoking adolescents and young adults (14–55 years) were enrolled in this observational cohort study.ResultsAdolescents had significantly higher fasting insulin (P=0.0002), insulin area under the curve [AUC] (P= 0.0004) and lower insulin sensitivity (P=0.0005) compared to adults. Among adolescents, AA race was significantly associated with BMD (β=0.086, P=0.01) and BMAD (β=0.0075, P=0.002); however, adjusting for insulin AUC explained this difference. Insulin AUC (β=0.0006, P=0.029) and fasting insulin (β=0.0005, P=0.01) were positively associated with BMAD only in AA adolescents. Insulin AUC and fasting insulin were not significant predictors of BMD for adults.ConclusionThe higher insulin concentration among AA adolescents is associated with increased BMD and higher BMAD.
Highlights
Insulin is considered to be an anabolic agent of bone by many authors [1,2,3,4,5]
AA race was significantly associated with bone mineral density (BMD) (β=0.086, P=0.01) and bone mineral apparent density (BMAD) (β=0.0075, P=0.002); adjusting for insulin area under the curve (AUC) explained this difference
It is widely reported that African Americans (AA) have a greater degree of insulin resistance compared to European Americans (EA) [8], and puberty is a developmental state of increased insulin resistance [9]
Summary
Insulin is considered to be an anabolic agent of bone by many authors [1,2,3,4,5]. recent investigations suggest a potential adverse influence of diabetes and pre-diabetes on the bone [6,7]. It is widely reported that African Americans (AA) have a greater degree of insulin resistance compared to European Americans (EA) [8], and puberty is a developmental state of increased insulin resistance [9]. Adolescence is considered to be the critical period during which thepeak bone mass' is achieved [10]. It is important to understand the relationships between insulin (especially insulin secretion and sensitivity) on BMC and BMD in healthy adolescents and adults and to identify if are any ethnic differences in these relationships. We hypothesized that the higher insulin concentrations will result in better bone mass and this may be more pronounced in AA adolescents due to their higher insulin concentrations. Puberty is a developmental stage of increased insulin resistance that is a critical period for bone mass accrual. The possibility that bone health and insulin secretion or concentrations are linked has not been investigated
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