Acta Obstet Gynecol Scand, 2020; 99 (4): 477-487, PMID: 31784976
Bone health in women with a history of gestational diabetes or obesity.
Year: 2020
Engberg E, Koivusalo SB, Huvinen E, Viljakainen H
Folkhalsan Institute of Genetics, Folkhalsan Research Center, Biomedicum Helsinki, Helsinki, Finland.
Abstract
INTRODUCTION: Type 2 diabetes is associated with an increased risk of bone fractures. However, bone health of women with a history of gestational diabetes (GDM) has received little attention. This cross-sectional study compares bone health between premenopausal women with and without a history of GDM, and examines factors associated with bone health in women with a history of GDM or obesity. MATERIAL AND METHODS: We measured areal bone mineral density for total hip, lumbar spine and whole body, and total body fat percentage (fat%) with dual-energy X-ray absorptiometry in 224 women. In addition, we measured bone characteristics of radius and tibia with peripheral quantitative computed tomography. RESULTS: When compared to women without a history of GDM (mean age 39 [SD 5], BMI 35 [6], fat% 48 [7]), women with a history of GDM (age 41 [4], BMI 31 [7], fat% 43 [10]) had lower hip and whole body bone mineral densities, and inferior tibia outcomes. However, the differences in bone characteristics attenuated after controlling for age, height, BMI and fat%. After controlling for age, height, BMI and smoking, physical activity and healthier diet were positively associated with bone outcomes, whereas fat%, HbA1c and screen time were negatively associated with bone outcomes. Particularly, fat% showed independent negative associations with whole body bone mineral density and several tibia and radius characteristics. CONCLUSIONS: Fat% is associated with adverse bone health, independently of BMI, in women with a history of GDM or obesity. Promoting healthy lifestyle and reducing fat% in women with a history of GDM or obesity could improve bone health and prevent future fractures.GID: 5000; Last update: 02.12.2019
