1203-P: Association of Bone Mineral Density (BMD) with Prediabetes in a Biracial Cohort

Background: Type 2 Diabetes (T2D) is associated with alterations in BMD, but association between prediabetes and BMD is less clear.

Subjects and Methods: We analyzed BMD in relation to demographic and metabolic parameters among the initially normoglycemic offspring of T2D parents in the POP-ABC (Pathobiology of Prediabetes in a Biracial Cohort) study. We further assessed the relationship between BMD and the risk of progression to prediabetes during 5 years of follow-up.

Results: A total of 376 participants underwent DEXA (Dual-energy X-ray absorptiometry) during Year 1 of POP-ABC and were followed quarterly for 5 years, the primary outcome being progression from normoglycemia to prediabetes. The mean age was 44.2 ± 10.6 years; BMI was 30.2 ± 7.23 kg/m2; 217 Black, 159 White, with 71% female. At baseline, the mean BMD was 1.176 ± 0.135 g/cm2 for the entire cohort; 1.230 ± 0.124 g/cm2 in men vs. 1.154 ± 0.134 g/cm2 in women (P<0.0001) ; 1.203 ± 0.114 g/cm2 in Black vs. 1.146 ± 0.150 g/cm2 in White participants (P=0.0003) . There was an inverse relationship between BMD and age (r= −0.254, P<0.0001) and a direct association with BMI (r=0.173, P=0.0028) and weight (r=0.315, P<0.0001) . The BMD showed no significant correlation with insulin secretion or insulin sensitivity. However, the BMD z score, which compares BMD to the average values for a person of same age and gender, was significantly correlated with risk of progression to prediabetes (r = 0.173, P=0.0029) and showed positive association with total body fat mass (r=0.208, p=0.0003) and trunk fat mass (r= 0.178, P= 0.0021) . BMD z score was not significantly correlated with either CRP or adiponectin level.

Conclusion: Among POP-ABC participants, BMD had the expected relationships with age, sex, and race. Higher BMD z score was predictive of progression to prediabetes among initially normoglycemic offspring of T2D parents during 5-year follow-up, an association that requires further mechanistic insights.