Assessment using serum insulin-like growth factor-I and bone mineral density is useful for detecting prevalent vertebral fractures in patients with type 2 diabetes mellitus.

Abstract

Bone mineral density (BMD) is less useful for evaluating fracture risk in type 2 diabetes. This study showed for the first time that combined evaluation by serum insulin-like growth factor-I and BMD is useful to assess the risk of vertebral fracture in postmenopausal women and men with type 2 diabetes.

INTRODUCTION:

BMD is less useful for evaluating fracture risk in type 2 diabetes mellitus (T2DM). We aimed to examine the usefulness of combined evaluation by BMD and serum insulin-like growth factor-I (IGF-I) to assess the risk of vertebral fracture (VF) in T2DM.

METHODS:

In this cross-sectional study, 412 postmenopausal women and 582 men with T2DM, whose BMD, bone turnover markers, and serum IGF-I were measured, were enrolled. The association of BMD alone, serum IGF-I alone, and combined assessment by BMD and IGF-I with the presence of VF was examined.

RESULTS:

Multiple logistic regression analyses showed that IGF-I as well as BMD T-score at lumbar (L) and femoral neck (FN) were significantly associated with VF except for IGF-I in men, respectively. Receiver operating characteristic curves showed that the cutoff values of IGF-I, L T-score and FN T-score were 127 ng/mL, - 1.78, and - 2.02 in postmenopausal women and 127 ng/mL, - 1.67, and - 1.24 in men. Based on the cutoff vales, the subjects were divided into four categories. The category of lower IGF-I and lower T-scores had a significant increased risk of VF compared to higher IGF-I and higher T-scores both in postmenopausal women and in men. The sensitivity and specificity of the combined assessment to detect VF were better compared to using BMD alone or IGF-I alone.

CONCLUSIONS:

This is the first study to show that in addition to BMD measurement, the assessment using serum IGF-I is useful to estimate the prevalence of VF in patients with T2DM.

• Authors: I Kanazawa, M Notsu, H Miyake, K Tanaka, T Sugimoto
• Journal: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (Osteoporos Int) Vol. 29 Issue 11 Pg. 2527-2535 (Nov 2018) ISSN: 1433-2965 [Electronic] England
• PMID: 30030585 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• IGF1 protein, human
• Insulin-Like Growth Factor I

Topics

• Aged
• Aged, 80 and over
• Biomarkers (blood)
• Bone Density (physiology)
• Bone Remodeling (physiology)
• Diabetes Mellitus, Type 2 (complications, physiopathology)
• Female
• Femur Neck (physiopathology)
• Humans
• Insulin-Like Growth Factor I (analysis)
• Lumbar Vertebrae (diagnostic imaging, physiopathology)
• Male
• Middle Aged
• Osteoporotic Fractures (diagnosis, etiology, physiopathology)
• Radiography
• Spinal Fractures (diagnosis, etiology, physiopathology)
• Thoracic Vertebrae (diagnostic imaging)