Abstract
BackgroundImpact of body fat distribution on bone mineral content (BMC) and density (BMD) at different sites has not been studied in type-2 diabetes (T2DM). This study aimed to compare BMC and BMD in normal (BMI < 25 kg/m2) and increased BMI (BMI ≥ 25 kg/m2) T2DM patients with age and BMI matched normal controls, and evaluate the impact of lean mass and body fat distribution parameters on them.MethodsSeventy-six T2DM patients and 56 normal controls underwent anthropometric assessment, blood sampling and estimation of BMC, BMD, body fat and lean mass distribution by dual energy X-ray absorptiometry (DXA).ResultsIncreased BMI individuals (n = 63) had significantly higher BMD, BMC, fat mass and significantly lower 25-hydroxy-vitamin-D (25OHD), as compared to normal BMI individuals (n = 69). Lean mass had stronger positive correlation with BMC and BMD, compared to fat mass. BMI, sagittal abdominal diameter (SAD) and Android/Gynoid (A/G) ratio had positive correlation with BMC and BMD. Percent body fat had negative correlation with BMC and BMD. T2DM patients had higher central obesity (A/G ratio). WC was the best predictor of A/G ratio. Regression analysis revealed lean mass to be the strongest predictor of BMC after adjusting for age, sex, BMI and 25OHD, in normal individuals and patients with diabetes, followed by fat mass. BMD right femur, BMC, lean mass and A/G ratios were significantly higher in males (n = 74). Fat mass and percent body fat were significantly higher in females (n = 58). Fat mass was the best predictor of BMC in males where as lean mass was the best predictor of BMC in females.ConclusionIncreased BMI and T2DM are associated with increased BMC and BMD at different sites, with lean mass having the strongest impact on BMC in normal individuals and patients with diabetes. Males have higher BMC and BMD as compared to females, likely due to a greater lean mass, A/G ratio, along with lesser fat mass and percent body fat.
Highlights
Type-2 diabetes (T2DM) has been associated with increased fracture risk with relative risk varying from 1.22.2 in different studies [1,2,3]
Seventy-six recently diagnosed T2DM patients and 56 normal controls who fulfilled all criteria were included in this study, which consisted of 74 males and 58 females
BMD right femur, bone mineral content (BMC), lean mass and A/G ratios were significantly higher in males, where as fat mass and percent body fat were significantly higher in females (Table 2)
Summary
Type-2 diabetes (T2DM) has been associated with increased fracture risk with relative risk varying from 1.22.2 in different studies [1,2,3]. Data on impact of body fat and lean mass distribution on BMD is available predominantly from post-menopausal women with or without osteoporosis [10,11,12,13,14,15]. Such studies among patients with diabetes are scanty, and are complicated by lack of adjustment for duration of diabetes, type of diabetes, use of glitazones and insulin. Impact of body fat distribution on bone mineral content (BMC) and density (BMD) at different sites has not been studied in type-2 diabetes (T2DM). This study aimed to compare BMC and BMD in normal (BMI < 25 kg/m2) and increased BMI (BMI ≥ 25 kg/m2) T2DM patients with age and BMI matched normal controls, and evaluate the impact of lean mass and body fat distribution parameters on them
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