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Yang R, Ding N, Qin J, Peng H. The relationship between uric acid and bone mineral density in the intermediate stage of CKD 1-3. BMC Nephrol 2024; 25:219. [PMID: 38982346 PMCID: PMC11234712 DOI: 10.1186/s12882-024-03650-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 06/24/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Some studies have suggested that uric acid has antioxidant properties that can prevent bone loss, but the relationship between uric acid and bone mineral density is controversial. The aim of this study was to investigate the relationship between UA and BMD in patients with CKD stage 1-3. METHODS We extracted 13,047 participants from the NHANES database, including 7342 male subjects and 5705 female subjects. Weighted multiple linear regression analysis was used to investigate the correlation between UA and BMD in patients with CKD stages 1-3. RESULTS In patients with CKD stage 1-3, UA was significantly correlated with BMD. In the male group, UA was positively associated with BMD (β, 7.94 [95%CI, 4.95, 10.94]). In the female group, there was a negative relationship between them (β, -5.33 [95%CI, -8.77, -1.89]). The relationship between UA and BMD in male group showed an inverted U-shaped curve, and UA was positively correlated before 6.1 mg/dl and negatively correlated after 6.1 mg/dl. The relationship was basically negative in the female group. CONCLUSIONS For the patients with CKD stage 1-3, the relationship between UA and BMD showed an inverted U-shaped curve in the males, while the relationship was largely negative in the females.
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Affiliation(s)
- Ruiling Yang
- Department of Nephrology, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, 161 Shaoshan South Road, Changsha, Hunan, 410004, China
| | - Ning Ding
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, 161 Shaoshan South Road, Changsha, Hunan, 410004, China.
| | - Jiao Qin
- Department of Nephrology, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, 161 Shaoshan South Road, Changsha, Hunan, 410004, China.
| | - Hongchun Peng
- Department of Orthopedics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, 161 Shaoshan South Road, Changsha, Hunan, 410004, China.
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Tu J, Mo X, Zhang X, Chen Z, Xi L, Wu C, Zeng X, Xie T. BMI mediates the association of serum uric acid with bone health: a cross-sectional study of the National Health and Nutrition Examination Survey (NHANES). BMC Musculoskelet Disord 2024; 25:482. [PMID: 38898434 PMCID: PMC11186245 DOI: 10.1186/s12891-024-07595-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/12/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND The associations between serum uric acid and osteoporosis or osteopenia remain controversial, and few studies have explored whether BMI acts as a mediators in the association between the SUA and OP/ osteopenia. OBJECTIVE To explore the relationship between serum uric acid and osteoporosis or osteopenia among US adults. METHODS A cross-sectional study was conducted to examine the association between serum uric acid and osteoporosis or osteopenia from four cycles of NHANES. Binary logistic regression models and restricted cubic spline models were used to evaluate the association between serum uric acid and osteoporosis or osteopenia, and interaction analysis was used to test the differences between subgroups. Mediation analysis was utilized to investigate whether BMI acts as a mediator in the association between SUA and OP/ osteopenia. RESULTS 12581 participants aged ≥ 18 years were included. A U-shape nonlinear relationship between SUA and osteoporosis or osteopenia in all people was found (P < 0.0001, P for nonlinear = 0.0287). There were significant interactions in age subgroups (P for interaction = 0.044), sex subgroups (P for interaction = 0.005), and BMI subgroups (P for interaction = 0.017). We further assessed the subgroups and found the optimal range of serum uric acid levels with a lower risk of osteoporosis or osteopenia was 357-535 µmol/L in males, 327-417 µmol/L in people aged ≥ 50 years, above 309 µmol/L in people aged < 50 years, 344-445 µmol/L in people with BMI ≥ 30, and above 308 µmol/L in people with BMI < 30. BMI fully mediated the association of SUA and OP/osteopenia, with a value of -0.0024(-0.0026--0.0021). These results were robust in sensitivity analyses. CONCLUSIONS A complicated relationship between SUA and bone health in different populations was observed. Maintaining SUA within a specific range may be beneficial to bone health. In addition, BMI may play an important role in the association between SUA and bone health, but considering the limitations of this study, further prospective research is required.
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Affiliation(s)
- Jiayuan Tu
- School of nursing and school of public health, Yangzhou University, Yangzhou, Jiangsu, 225000, China
| | - Xiaoqiao Mo
- Department of Operating Room, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200000, China
| | - Xiangda Zhang
- Department of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 276199, Australia
| | - Zihao Chen
- College of Physical education, Yangzhou University, Yangzhou, Jiangsu, 225000, China
| | - Lijuan Xi
- School of nursing and school of public health, Yangzhou University, Yangzhou, Jiangsu, 225000, China
| | - Chunhui Wu
- Department of Cardiology, Zhongda Hospital Southeast University, Nanjing, Jiangsu, 210000, China
| | - Xiangchan Zeng
- Gynacology Department, Shenzhen Nanshan Medical Group Headquarter, Shenzhen, Guangdong, 518000, China.
| | - Tian Xie
- Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200000, China.
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Chen SY, Liao J, Huang PX, Wu KF, Deng LM. Bibliometric and visualized analysis of type 2 diabetic osteoporosis from 2013 to 2022. Arch Osteoporos 2024; 19:30. [PMID: 38647606 DOI: 10.1007/s11657-024-01386-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Abstract
Type 2 diabetic osteoporosis (T2DOP) has received increasing attention from researchers. In this study, a total of 453 publications related to T2DOP from 2013 to 2022 were analyzed using bibliometric and visual analysis to identify the research trends and research hotspots in the field of T2DOP. PURPOSE The objective of this study was to conduct a comprehensive bibliometric analysis of T2DOP-related publications from 2013 to 2022 to determine global research trends in T2DOP in terms of number of publications, countries/regions, institutions, authors, journals, funding agencies, and keywords. METHODS All data were collected from the Web of Science Core Collection (WoSCC). All original research publications regarding T2DOP from 2013 to 2022 were retrieved. VOSviewer and Microsoft Office Excel were used to conduct the bibliometric and visual analysis. RESULTS From 2013 to 2022, 515 relevant publications were published, with a peak in 2022 in the annual number of publications. The countries leading the research were USA and China. Sugimoto was the most influential authors. Capital Medical University and Nanjing Medical University were the most prolific institutions. Osteoporosis International was the most productive journal concerning T2DOP research. National Natural Science Foundation of China was the primary funding source for this research area. "Bone-mineral density", "fracture risk", and "postmenopausal women" were the most high-frequency keywords over the past 10 years. CONCLUSION This was the first bibliometric study of diabetes mellitus and osteoporosis to exclusively examine type 2 diabetes mellitus. Our findings would provide guidance to understand the research frontiers and hot directions in the near future.
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Affiliation(s)
- Si-Yu Chen
- Marine Biomedical Research Institution, Guangdong Medical University, Zhanjiang, 524023, People's Republic of China
- Marine Biomedical Research Institution of Guangdong Zhanjiang, Zhanjiang, 524023, People's Republic of China
| | - Jing Liao
- The Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524023, People's Republic of China
| | - Pei-Xin Huang
- Marine Biomedical Research Institution, Guangdong Medical University, Zhanjiang, 524023, People's Republic of China
- Marine Biomedical Research Institution of Guangdong Zhanjiang, Zhanjiang, 524023, People's Republic of China
| | - Ke-Feng Wu
- Marine Biomedical Research Institution, Guangdong Medical University, Zhanjiang, 524023, People's Republic of China.
- Marine Biomedical Research Institution of Guangdong Zhanjiang, Zhanjiang, 524023, People's Republic of China.
- GuangDong Engineering Technology Research Center for the Development and Utilization of Mangrove Wetland Medicinal Resources, Guangdong Medical University, Zhanjiang, 524023, People's Republic of China.
| | - Lu-Ming Deng
- Marine Biomedical Research Institution, Guangdong Medical University, Zhanjiang, 524023, People's Republic of China.
- Marine Biomedical Research Institution of Guangdong Zhanjiang, Zhanjiang, 524023, People's Republic of China.
- GuangDong Engineering Technology Research Center for the Development and Utilization of Mangrove Wetland Medicinal Resources, Guangdong Medical University, Zhanjiang, 524023, People's Republic of China.
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Xu N, Wang Y, Chen Y, Guo YN, Li RX, Zhou YM, Xu J. The associations between uric acid with BMDs and risk of the 10-year probability of fractures in Chinese patients with T2DM stratified by age and gender. Endocrine 2023; 80:520-528. [PMID: 36991286 DOI: 10.1007/s12020-023-03353-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 03/07/2023] [Indexed: 03/31/2023]
Abstract
PURPOSE Accumulating evidence suggests that serum uric acid (SUA) plays a beneficial role in bone health in the general population through antioxidant mechanisms. However, there is controversy over the association between SUA and bone in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the association of serum UA with BMDs and future fracture risks and its potential influencing factors in those patients. METHOD This was a cross-sectional study of 485 patients. BMDs at femoral neck (FN), Troch and the lumbar spine (LS) were measured by DXA. The 10-year probability of fracture risk was assessed using the fracture risk assessment tool (FRAX). SUA level and other biochemical indexes were measured. RESULTS There were lower SUA concentrations in patients with osteoporosis/osteopenia compared with those in the normal group, which only existed in non-elderly men and elderly women with T2DM. After adjustment for potential confounders, SUA was positively associated with BMD and negatively with 10-year probability of fracture risk only in non-elderly men and elderly women with T2DM. Multiple stepwise regression analysis showed that SUA was an independent determinant of BMD and 10-year probability of fracture risk, which also occurred in the above patients. CONCLUSION These results implied that relatively high SUA is a protective factor for bone in T2DM patients, but the osteoprotective effect of SUA was mediated by age and gender, and persisted only in non-elderly men and elderly women. Large intervention studies are needed to further confirm the outcomes and provide possible explanations.
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Affiliation(s)
- Na Xu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, 250021, Shandong, China
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, 250021, Shandong, China
- Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, 250021, Shandong, China
| | - Yan Wang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, 250021, Shandong, China
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, 250021, Shandong, China
- Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, 250021, Shandong, China
| | - Yu Chen
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, 250021, Shandong, China
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, 250021, Shandong, China
- Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, 250021, Shandong, China
| | - Yu-Ning Guo
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, 250021, Shandong, China
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, 250021, Shandong, China
- Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, 250021, Shandong, China
| | - Ren-Xuan Li
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, 250021, Shandong, China
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, 250021, Shandong, China
- Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, 250021, Shandong, China
- Department of Endocrinology, Shandong Provincial Hospital, Jinan, 250021, Shandong, China
| | - Yan-Man Zhou
- Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
| | - Jin Xu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, 250021, Shandong, China.
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, 250021, Shandong, China.
- Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, 250021, Shandong, China.
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Hassanabadi N, Berger C, Papaioannou A, Cheung AM, Rahme E, Leslie WD, Goltzman D, Morin SN. Variation in bone mineral density and fractures over 20 years among Canadians: a comparison of the Canadian Multicenter Osteoporosis Study and the Canadian Longitudinal Study on Aging. Osteoporos Int 2023; 34:357-367. [PMID: 36449036 PMCID: PMC9852141 DOI: 10.1007/s00198-022-06623-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022]
Abstract
UNLABELLED International variations in osteoporosis and fracture rates have been reported, with temporal trends differing between populations. We observed higher BMD and lower fracture prevalence in a recently recruited cohort compared to that of a cohort recruited 20 years ago, even after adjusting for multiple covariates. PURPOSE We explored sex-specific differences in femoral neck bone mineral density (FN-BMD) and in prevalent major osteoporotic fractures (MOF) using two Canadian cohorts recruited 20 years apart. METHODS We included men and women aged 50-85 years from the Canadian Multicentre Osteoporosis Study (CaMos, N = 6,479; 1995-1997) and the Canadian Longitudinal Study on Aging (CLSA, N = 19,534; 2012-2015). We created regression models to compare FN-BMD and fracture risk between cohorts, adjusting for important covariates. Among participants with prevalent MOF, we compared anti-osteoporosis medication use. RESULTS Mean (SD) age in CaMos (65.4 years [8.6]) was higher than in CLSA (63.8 years [9.1]). CaMos participants had lower mean body mass index and higher prevalence of smoking (p < 0.001). Adjusted linear regression models (estimates [95%CI]) demonstrated lower FN-BMD in CaMos women (- 0.017 g/cm2 [- 0.021; - 0.014]) and men (- 0.006 g/cm2 [- 0.011; 0.000]), while adjusted odds ratios (95%CI) for prevalent MOF were higher in CaMos women (1.99 [1.71; 2.30]) and men (2.33 [1.82; 3.00]) compared to CLSA. In women with prevalent MOF, menopausal hormone therapy use was similar in both cohorts (43.3% vs 37.9%, p = 0.076), but supplements (32.0% vs 48.3%, p < 0.001) and bisphosphonate use (5.8% vs 17.3%, p < 0.001) were lower in CaMos. The proportion of men with MOF who received bisphosphonates was below 10% in both cohorts. CONCLUSION Higher BMD and lower fracture prevalence were noted in the more recently recruited CLSA cohort compared to CaMos, even after adjusting for multiple covariates. We noted an increase in bisphosphonate use in the recent cohort, but it remained very low in men.
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Affiliation(s)
- Nazila Hassanabadi
- Department of Medicine, McGill University, Montreal, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada
| | - Claudie Berger
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada
| | | | - Angela M Cheung
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Elham Rahme
- Department of Medicine, McGill University, Montreal, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada
| | - William D Leslie
- Department of Medicine, University of Manitoba, Winnipeg, Canada
| | - David Goltzman
- Department of Medicine, McGill University, Montreal, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada
| | - Suzanne N Morin
- Department of Medicine, McGill University, Montreal, Canada.
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada.
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Robles-Rivera K, Argoty-Pantoja AD, Hidalgo-Bravo A, Quezada-Sánchez AD, León-Reyes G, Flores YN, Salmerón J, Velázquez-Cruz R, Rivera-Paredez B. Uric Acid Levels Are Associated with Bone Mineral Density in Mexican Populations: A Longitudinal Study. Nutrients 2022; 14:nu14204245. [PMID: 36296929 PMCID: PMC9612067 DOI: 10.3390/nu14204245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/05/2022] [Accepted: 10/09/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Inconsistent epidemiological evidence between uric acid (UA) and bone mineral density (BMD) has been observed. Therefore, we evaluated the association between UA and BMD in Mexican adults. Methods: This analysis was conducted on 1423 participants from the Health Workers Cohort Study. We explored cross-sectional associations using linear regression and longitudinal associations using fixed-effects linear regression by sex and age groups (<45 and ≥45 years). Results: In females <45 years old, the cross-sectional analysis showed that UA levels were positively associated with total hip BMD. However, in the longitudinal analysis, we observed a negative association with the femoral neck and lumbar spine BMD. In contrast, in males <45 years old, we found an increase in total hip and femoral neck BMD in the groups with high levels of UA in the longitudinal association. On the other hand, in females ≥45 years old, we observed a longitudinal association between UA and loss of BMD at different sites. We did not observe an association between UA levels and BMD in males ≥45 years old. Conclusions: Our results suggest higher serum UA levels are associated with low BMD at different skeletal sites in Mexican females. Further studies are needed to delineate the underlying mechanisms behind this observation.
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Affiliation(s)
- Karina Robles-Rivera
- Research Center in Policies, Population and Health, School of Medicine, National Autonomous University of Mexico (UNAM), Mexico City 04510, Mexico
| | - Anna D. Argoty-Pantoja
- Research Center in Policies, Population and Health, School of Medicine, National Autonomous University of Mexico (UNAM), Mexico City 04510, Mexico
| | - Alberto Hidalgo-Bravo
- Department of Genetics, National Institute of Rehabilitation (INR), Mexico City 014389, Mexico
| | - Amado D. Quezada-Sánchez
- Center for Evaluation and Surveys Research, National Institute of Public Health (INSP), Cuernavaca 62100, Mexico
| | - Guadalupe León-Reyes
- Genomics of Bone Metabolism Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City 14610, Mexico
| | - Yvonne N. Flores
- Epidemiological and Health Services Research Unit, Morelos Delegation, Mexican Institute of Social Security, Cuernavaca 62000, Mexico
- Department of Health Policy and Management and UCLA-Kaiser Permanente Center for Health Equity, Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA
- UCLA Center for Cancer Prevention and Control Research, Fielding School of Public Health, Los Angeles, CA 90095, USA
- Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095, USA
| | - Jorge Salmerón
- Research Center in Policies, Population and Health, School of Medicine, National Autonomous University of Mexico (UNAM), Mexico City 04510, Mexico
| | - Rafael Velázquez-Cruz
- Genomics of Bone Metabolism Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City 14610, Mexico
| | - Berenice Rivera-Paredez
- Research Center in Policies, Population and Health, School of Medicine, National Autonomous University of Mexico (UNAM), Mexico City 04510, Mexico
- Correspondence: ; Tel.: +52-55-56-22-66-66 (ext. 82355)
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Huang R, Wang H, Shen Z, Cai T, Zhou Y, Wang Y, Xia W, Ding B, Yan R, Li H, Wu J, Ma J. Increased Glycemic Variability Evaluated by Continuous Glucose Monitoring is Associated with Osteoporosis in Type 2 Diabetic Patients. Front Endocrinol (Lausanne) 2022; 13:861131. [PMID: 35733774 PMCID: PMC9207512 DOI: 10.3389/fendo.2022.861131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/04/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Subjects with type 2 diabetes mellitus (T2DM) are susceptible to osteoporosis. This study was conducted to evaluate the association between glycemic variability evaluated by continuous glucose monitoring (CGM) and osteoporosis in type 2 diabetic patient. METHODS A total of 362 type 2 diabetic subjects who underwent bone mineral density (BMD) measurement and were monitored by a CGM system from Jan 2019 to May 2020 were enrolled in this cross-sectional study. Glycemic variability was calculated with the Easy GV software, including 24-hour mean blood glucose (24-h MBG), the standard deviation of 24-h MBG (SDBG), coefficient of variation (CV), mean amplitude of glycemic excursions (MAGE), and time in range between 3.9 and 10.0 mmol/L (TIR). Other potential influence factors for osteoporosis were also examined. RESULTS Based on the T-scores of BMD measurement, there were 190 patients with normal bone mass, 132 patients with osteopenia and 40 patients with osteoporosis. T2DM patients with osteoporosis showed a higher 24-h MBG, SDBG, CV, and MAGE, but a lower TIR (all p < 0.05). Multivariate logistic regression analysis revealed that age, female gender, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), serum uric acid (SUA) and MAGE independently contribute to osteoporosis, and corresponding odds ratio [95% confidence interval (CI)] was 1.129 (1.072-1.190), 4.215 (1.613-11.012), 0.801 (0.712-0.901), 2.743 (1.385-5.431), 0.993 (0.988-0.999), and 1.380 (1.026-1.857), respectively. Further receiver operating characteristic analysis with Youden index indicated that the area under the curve and its 95% CI were 0.673 and 0.604-0.742, with the optimal cut-off value of MAGE predicting osteoporosis being 4.31 mmol/L. CONCLUSION In addition to conventional influence factors including age, female gender, BMI, LDL-C and SUA, increased glycemic variability assessed by MAGE is associated with osteoporosis in type 2 diabetic patients.
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