Background: To explore the relationship between insulin resistance and osteoporosis risk in Chinese patients with type 2 diabetes mellitus (T2DM).
Methods: A total of 234 T2DM patients were retrospectively analyzed, and their lumbar bone mineral density (BMD) and insulin resistance using C-peptide-based homeostasis model of insulin resistance [HOMA-IR (CP)] were assessed. Univariate and multivariable logistic regression methods were used to evaluate the association between HOMA-IR (CP) and osteoporosis, and subgroup analysis was performed on female and male patients.
Results: After fully adjusting the covariates, the association between HOMA-IR (CP) and osteoporosis was only significant in female patients (P = 0.022); the interaction effect with gender was significant (P for interaction < 0.05). Curve fitting showed that the relationship between HOMA-IR (CP) and osteoporosis in women was nonlinear. When HOMA-IR (CP) is < 4.00, its effect on osteoporosis was not significant (P = 0.474); when HOMA-IR (CP) is > 4.00, the risk of osteoporosis increased significantly, with OR = 26.88 (95% CI: 2.75– 262.69, P = 0.005). The relationship between insulin resistance and osteoporosis risk in T2DM patients is significantly affected by gender.
Conclusion: The higher the degree of insulin resistance in female patients, the greater the risk of osteoporosis, but the two are not linearly associated.
Keywords: type 2 diabetes mellitus, insulin resistance, osteoporosis, bone mineral density, homeostasis model assessment for insulin resistance