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Association of Insulin Resistance with Lower Bone Volume and Strength Index of the Proximal Femur in Nondiabetic Postmenopausal Women

 Jaewon Yang  ;  Namki Hong  ;  Jee-Seon Shim  ;  Yumie Rhee  ;  Hyeon Chang Kim 
 JBM : Journal of Bone Metabolism, Vol.25(2) : 123-132, 2018 
Journal Title
 JBM : Journal of Bone Metabolism 
Issue Date
Bone density ; Femur ; Insulin resistance ; Osteoporosis ; Postmenopause
Background: Type 2 diabetes mellitus is associated with an increased risk of osteoporotic fracture despite relatively preserved bone mineral density (BMD). Although this paradox might be attributed to the influence of insulin resistance (IR) on bone structure and material properties, the association of IR with femur bone geometry and strength indices remains unclear. Methods: Using data from the Cardiovascular and Metabolic Disease Etiology Research Center cohort study, we conducted a cross-sectional analysis among nondiabetic postmenopausal women. IR was estimated using the homeostasis model assessment of IR (HOMA-IR). Compartment-specific volumetric BMD (vBMD) and bone volume of proximal femur were measured using quantitative computed tomography. The compressive strength index (CSI), section modulus (Z), and buckling ratio of the femoral neck were calculated as bone strength indices. Results: Among 1,008 subjects (mean age, 57.3 years; body mass index [BMI], 23.6 kg/m(2)), BMI, waist circumference, and vBMD of the femoral neck and total hip increased in a linear trend from the lowest (<1.37) to highest (>/=2.27) HOMA-IR quartile (P<0.05 for all). The HOMA-IR showed an independent negative association with total bone volume (standardized beta=-0.12), cortical volume (beta=-0.05), CSI (beta=-0.013), and Z (beta=-0.017; P<0.05 for all) of the femoral neck after adjustment for age, weight, height, physical activity, and vitamin D and high-sensitivity C-reactive protein levels. However, the association between HOMA-IR and vBMD was attenuated in the adjusted model (femoral neck, beta=0.94; P=0.548). Conclusions: Elevated HOMA-IR was associated with lower cortical bone volume and bone strength indices in nondiabetic postmenopausal women, independent of age and body size.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyeon Chang(김현창) ORCID logo https://orcid.org/0000-0001-7867-1240
Shim, Jee Seon(심지선) ORCID logo https://orcid.org/0000-0002-8671-3153
Rhee, Yumie(이유미) ORCID logo https://orcid.org/0000-0003-4227-5638
Hong, Nam Ki(홍남기) ORCID logo https://orcid.org/0000-0002-8246-1956
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