Insulin Resistance in Type 2 Diabetes Mellitus May Be Related to Bone Mineral Density

The mechanism of bone mineral density (BMD) changes in type 2 diabetes mellitus is not clear. We aimed to investigate the effect of insulin resistance in type 2 diabetics on BMD. Insulin resistance was determined using the homeostasis model assessment index (HOMA-IR). Nineteen type 2 diabetic patients with a HOMA-IR < 2.7 (mean age, 51.5 +/- 9.6 yr; body mass index [BMI] 27.3 +/- 5.1 kg/m(2); duration of diabetes, 10.5 +/- 7.3 yr) were included in Group A, and 30 BMI- and age-matched type 2 diabetic patients with a HOMA-IR >= 2.7 were included in Group B. The BMD was measured with dual-energy X-ray absorptiometry. Independent t-test was used for statistical analysis. The Group A values for mean fasting glucose and insulin levels were 160.1 +/- 77.0 mg/dL and 4.79 +/- 2.89 mu U/L, respectively, whereas the Group B values were 195.1 +/- 58.9 mg/dL (p > 0.05) and 19.30 +/- 16.89 mu U/L (p = 0.0001). Significantly higher total lumbar vertebra T-score (p = 0.02) and total lumbar vertebra BMD in Group A were determined than Group B (p = 0.033). The lumbar vertebra total Z-score was significantly lower in Group B (p = 0.042). Marked insulin resistance may have a negative effect on BMD in type 2 diabetics, while the presence of hyperinsulinemia may be associated with the low BMD.