Normoglycemic postmenopausal women with a first-degree family history of diabetes have increased bone mineral density (BMD) with insulin resistance and hyperinsulinemia, according to study results published in Menopause.

The study included normoglycemic postmenopausal women (N=892). Participants were divided into subgroups based on whether or not they had a first-degree family history of diabetes. All patients had undergone dual-energy x-ray absorptiometry to measure BMD. Researchers also measured fasting serum insulin and glucose levels. Insulin resistance was evaluated using the homeostatic model assessment of insulin resistance (HOMA-IR) index.

The results indicated that participants with a first-degree family history of diabetes had significantly higher BMD at the lumbar spine and femoral neck compared with those without a family history of diabetes (all P <.05). Both lumbar spine and femoral neck BMD were positively associated with HOMA-IR score (P =.041 and P =.005, respectively).

After performing multiple stepwise regression analyses, the researchers found that a first-degree family history of diabetes was independently associated with lumbar spine BMD (standardized β=0.112; P =.001) and femoral neck BMD (standardized β=0.075; P =.029).

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Women with a first-degree family history of diabetes also had significantly higher levels of fasting serum insulin and hemoglobin A1c, as well as higher HOMA-IR scores compared with women who did not have a family history of diabetes (all P <.05).

The study had several limitations, including its cross-sectional design and lack of assessment of bone turnover markers. In addition, the researchers noted that BMD measurements can underestimate skeletal fragility in patients with type 2 diabetes and those in the early stages of diabetes.

“[F]uture studies are needed to examine the changes in BMD with the evolution of the disease from prediabetes to overt diabetes,” the researchers wrote.

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Reference

Yang L, Hu X, Zhang H, Pan W, Yu W, Gu X. Association of bone mineral density with a first-degree family history of diabetes in normoglycemic postmenopausal women [published online August 19, 2019]. Menopause. doi:10.1097/GME.0000000000001396