Clin Endocrinol (Oxf), 2019; 90(5): 680-689, PMID: 30724369

Sex-specific associations between insulin resistance and bone parameters in overweight and obese older adults.

Year: 2019

Mesinovic J, McMillan LB, Shore-Lorenti C, Zengin A, De Courten B, Ebeling PR, Scott D
Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia.

Abstract

OBJECTIVES: To determine sex-specific associations between insulin resistance and bone parameters measured by peripheral quantitative computed tomography (pQCT) in overweight and obese community-dwelling older adults. STUDY DESIGN: Cross-sectional study of 79 community-dwelling overweight and obese adults (mean+/-SD age 62.8+/-7.9 years; BMI 32.3+/-6.1 kg/m(2) ; 58% women). MAIN OUTCOME MEASURES: pQCT assessed distal radius and tibia trabecular volumetric bone mineral density (vBMD) and proximal radius and tibia cortical vBMD, periosteal circumference, endosteal circumference and stress-strain index (SSI). The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) score was calculated from fasting glucose and insulin values. Lean mass was assessed using dual-energy X-ray absorptiometry (DXA). Total minutes of moderate and vigorous physical activity (MVPA) was calculated using the Active Australia Survey. RESULTS: Men and women in this cohort had no significant differences in fasting glucose and insulin concentrations, HOMA-IR and diabetes prevalence (all P>0.05). In women, HOMA-IR was positively correlated with proximal radius periosteal and endosteal circumference (r=0.331; P=0.034 and r=0.325; P=0.038, respectively). These associations became non-significant in multivariable regression analyses, however, HOMA-IR was negatively associated with proximal radius cortical vBMD (B=-4.79; 95% CI -8.66, -0.92) after adjusting for age, lean mass and MVPA. All associations between HOMA-IR and bone parameters became non-significant in a sensitivity analysis excluding individuals with diabetes, or self-reported use of glucose-lowering medications. There were no associations between HOMA-IR and bone parameters in men. CONCLUSIONS: HOMA-IR was negatively associated with radial cortical vBMD in overweight and obese older women, but not in men. Further studies are needed to clarify sex-specific associations between insulin resistance and bone health in overweight and obese older adults. This article is protected by copyright. All rights reserved.

GID: 4853; Last update: 13.02.2019