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Insulin resistance is associated with smaller cortical bone size in nondiabetic men at the age of peak bone mass

Charlotte Verroken (UGent) , Hans-Georg Zmierczak (UGent) , Stefan Goemaere (UGent) , Jean Kaufman (UGent) and Bruno Lapauw (UGent)
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Abstract
Context: In type 2 diabetes mellitus, fracture risk is increased despite preserved areal bone mineral density. Although this apparent paradox may in part be explained by insulin resistance affecting bone structure and/or material properties, few studies have investigated the association between insulin resistance and bone geometry. Objective: We aimed to explore this association in a cohort of nondiabetic men at the age of peak bone mass. Design, Setting, and Participants: Nine hundred ninety-six nondiabetic men aged 25 to 45 years were recruited in a cross-sectional, population-based sibling pair study at a university research center. Main Outcome Measures: Insulin resistance was evaluated using the homeostasis model assessment of insulin resistance (HOMA-IR), with insulin and glucose measured from fasting serum samples. Bone geometry was assessed using peripheral quantitative computed tomography at the distal radius and the radial and tibial shafts. Results: In age-, height-, and weight-adjusted analyses, HOMA-IR was inversely associated with trabecular area at the distal radius and with cortical area, periosteal and endosteal circumference, and polar strength strain index at the radial and tibial shafts (beta <= -0.13, P < 0.001). These associations remained essentially unchanged after additional adjustment for dual-energy X-ray absorptiometry-derived body composition, bone turnover markers, muscle size or function measurements, or adiponectin, leptin, insulin-like growth factor 1, or sex steroid levels. Conclusion: In this cohort of nondiabetic men at the age of peak bone mass, insulin resistance is inversely associated with trabecular and cortical bone size. These associations persist after adjustment for body composition, muscle size or function, or sex steroid levels, suggesting an independent effect of insulin resistance on bone geometry.
Keywords
HOMEOSTASIS MODEL ASSESSMENT, TYPE-2 DIABETES-MELLITUS, HEALTHY MALE SIBLINGS, SKELETAL-MUSCLE MASS, BETA-CELL FUNCTION, POSTMENOPAUSAL WOMEN, FRACTURE RISK, PHYSICAL-ACTIVITY, OBESE CHILDREN, SERUM-INSULIN

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Chicago
Verroken, Charlotte, Hans-Georg Zmierczak, Stefan Goemaere, Jean Kaufman, and Bruno Lapauw. 2017. “Insulin Resistance Is Associated with Smaller Cortical Bone Size in Nondiabetic Men at the Age of Peak Bone Mass.” Journal of Clinical Endocrinology & Metabolism 102 (6): 1807–1815.
APA
Verroken, C., Zmierczak, H.-G., Goemaere, S., Kaufman, J., & Lapauw, B. (2017). Insulin resistance is associated with smaller cortical bone size in nondiabetic men at the age of peak bone mass. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 102(6), 1807–1815.
Vancouver
1.
Verroken C, Zmierczak H-G, Goemaere S, Kaufman J, Lapauw B. Insulin resistance is associated with smaller cortical bone size in nondiabetic men at the age of peak bone mass. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM. 2017;102(6):1807–15.
MLA
Verroken, Charlotte et al. “Insulin Resistance Is Associated with Smaller Cortical Bone Size in Nondiabetic Men at the Age of Peak Bone Mass.” JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM 102.6 (2017): 1807–1815. Print.
@article{8504113,
  abstract     = {Context: In type 2 diabetes mellitus, fracture risk is increased despite preserved areal bone mineral density. Although this apparent paradox may in part be explained by insulin resistance affecting bone structure and/or material properties, few studies have investigated the association between insulin resistance and bone geometry. 
Objective: We aimed to explore this association in a cohort of nondiabetic men at the age of peak bone mass. 
Design, Setting, and Participants: Nine hundred ninety-six nondiabetic men aged 25 to 45 years were recruited in a cross-sectional, population-based sibling pair study at a university research center. 
Main Outcome Measures: Insulin resistance was evaluated using the homeostasis model assessment of insulin resistance (HOMA-IR), with insulin and glucose measured from fasting serum samples. Bone geometry was assessed using peripheral quantitative computed tomography at the distal radius and the radial and tibial shafts. 
Results: In age-, height-, and weight-adjusted analyses, HOMA-IR was inversely associated with trabecular area at the distal radius and with cortical area, periosteal and endosteal circumference, and polar strength strain index at the radial and tibial shafts (beta <= -0.13, P < 0.001). These associations remained essentially unchanged after additional adjustment for dual-energy X-ray absorptiometry-derived body composition, bone turnover markers, muscle size or function measurements, or adiponectin, leptin, insulin-like growth factor 1, or sex steroid levels. 
Conclusion: In this cohort of nondiabetic men at the age of peak bone mass, insulin resistance is inversely associated with trabecular and cortical bone size. These associations persist after adjustment for body composition, muscle size or function, or sex steroid levels, suggesting an independent effect of insulin resistance on bone geometry.},
  author       = {Verroken, Charlotte and Zmierczak, Hans-Georg and Goemaere, Stefan and Kaufman, Jean and Lapauw, Bruno},
  issn         = {0021-972X},
  journal      = {JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM},
  keywords     = {HOMEOSTASIS MODEL ASSESSMENT,TYPE-2 DIABETES-MELLITUS,HEALTHY MALE SIBLINGS,SKELETAL-MUSCLE MASS,BETA-CELL FUNCTION,POSTMENOPAUSAL WOMEN,FRACTURE RISK,PHYSICAL-ACTIVITY,OBESE CHILDREN,SERUM-INSULIN},
  language     = {eng},
  number       = {6},
  pages        = {1807--1815},
  title        = {Insulin resistance is associated with smaller cortical bone size in nondiabetic men at the age of peak bone mass},
  url          = {http://dx.doi.org/10.1210/jc.2016-3609},
  volume       = {102},
  year         = {2017},
}

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