Bone Mass and Density in Youth with Type 2 Diabetes, Obesity, and Healthy Weight
Research Design and Methods: 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). Whole body (less head) aBMD and lean mass, and abdominal visceral fat were assessed via DXA. Lean body mass index (LBMI) and aBMD standard deviation (SD) scores (“Z-scores”) were computed using published reference data.
Results: We observed age-dependent differences 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 vs obese groups, but in adolescents and young adults, aBMD and LBMI Z-scores were lower in the type 2 diabetes vs. obese group (age interactions P<0.05). In the type 2 diabetes and obese groups, aBMD was about 0.5 SDs lower for a given LBMI Z-score compared to healthy weight controls (P<0.05). Further, aBMD was lower in those with greater visceral fat (β=-0.121, P=0.047).
Conclusions: These results suggest that type 2 diabetes may be detrimental to bone density around the age of peak bone mass. 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.