Study on Bone Density and Type 2 Diabetes

Around the age of peak bone mass, type 2 diabetes (T2D) may be detrimental to bone density, suggests a recent study in the journal Diabetes Care. The findings are significant given the increased risk of fracture in T2D adults.

There is an increasing incidence of youth-onset type 2 diabetes, an aggressive condition. T2D adults are at increased fracture risk despite normal areal bone mineral density (aBMD), but there is no information on the influence of diabetes on the growing skeleton. Joseph M. Kindler, Children's Hospital of Philadelphia, Philadelphia, PA, and colleagues compared bone health in youth with type 2 diabetes to control patients with obesity or healthy weight.

The researchers conducted a cross-sectional study of youth (56% African American, 67% female) ages 10–23 years with type 2 diabetes (n = 180), obesity (BMI >95th; n = 226), or healthy weight (BMI <85th; n = 238). They assessed the whole body (less head) aBMD and lean mass as well as abdominal visceral fat via DXA. Lean BMI (LBMI) and aBMD SD scores (z scores) were computed using published reference data.

Key Findings of the Study

• Age-dependent differences were observed 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 group versus the obese group, but in adolescents and young adults, aBMD and LBMI z scores were lower in the type 2 diabetes group versus the obese group.
• In the type 2 diabetes group and the obese group, aBMD was about 0.5 SDs lower for a given LBMI z score compared with healthy weight control patients.
• aBMD was lower in those with greater visceral fat.

"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," concluded the authors.

The study, "Bone Mass and Density in Youth With Type 2 Diabetes, Obesity, and Healthy Weight," is published in the journal Diabetes Care.

DOI: https://doi.org/10.2337/dc19-2164