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).
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.
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