Artificial intelligence–based diabetes risk prediction from longitudinal DXA bone measurements

Abstract Diabetes mellitus (DM) is a serious global health concern that poses a significant threat to human life. Beyond its direct impact, diabetes substantially increases the risk of developing severe complications such as hypertension, cardiovascular disease, and musculoskeletal disorders like ar...

Full description

Saved in:
Bibliographic Details
Main Authors: Sulaiman Khan, Zubair Shah
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-025-10136-5
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849332986953072640
author Sulaiman Khan
Zubair Shah
author_facet Sulaiman Khan
Zubair Shah
author_sort Sulaiman Khan
collection DOAJ
description Abstract Diabetes mellitus (DM) is a serious global health concern that poses a significant threat to human life. Beyond its direct impact, diabetes substantially increases the risk of developing severe complications such as hypertension, cardiovascular disease, and musculoskeletal disorders like arthritis and osteoporosis. The field of diabetes classification has advanced significantly with the use of diverse data modalities and sophisticated tools to identify individuals or groups as diabetic. But the task of predicting diabetes prior to its onset, particularly through the use of longitudinal multi-modal data, remains relatively underexplored. To better understand the risk factors associated with diabetes development among Qatari adults, this longitudinal research aims to investigate dual-energy X-ray absorptiometry (DXA)-derived whole-body and regional bone composition measures as potential predictors of diabetes onset. We proposed a case—control retrospective study, with a total of 1,382 participants contains 725 male participants (cases: 146, control: 579) and 657 female participants (case: 133, control: 524). We excluded participants with incomplete data points. To handle class imbalance, we augmented our data using Synthetic Minority Over-sampling Technique (SMOTE) and SMOTEENN (SMOTE with Edited Nearest Neighbors), and to further investigated the association between bones data features and diabetes status, we employed ANOVA analytical method. For diabetes onset prediction, we employed both conventional and deep learning (DL) models to predict risk factors associated with diabetes in Qatari adults. We used SHAP and probabilistic methods to investigate the association of identified risk factors with diabetes. During experimental analysis, we found that bone mineral density (BMD), bone mineral contents (BMC) in the hip, femoral neck, troch area, and lumbar spine showed an upward trend in diabetic patients with $$p-value \ge 0.001$$ . Meanwhile, we found that patients with abnormal glucose metabolism had increased wards BMD and BMC with low Z-score compared to healthy participants. Consequently, it shows that the diabetic group has superior bone health than the control group in the cohort, because they exhibit higher BMD, muscle mass, and bone area across most body regions. Moreover, in the age group distribution analysis, we found that the diabetes prediction rate was higher among healthy participants in the younger age group 20–40 years. But as the age range increased, the model predictions became more accurate for diabetic participants, especially in the older age group 56–69 years. It is also observed that male participants demonstrated a higher susceptibility to diabetes onset compared to female participants. Shallow models outperformed the DL models by presenting improved accuracy (91.08%), AUROC (96%), and recall values (91%). This pivotal approach utilizing DXA scans highlights significant potential for the rapid and minimally invasive early detection of diabetes.
format Article
id doaj-art-a4c6ec52f72c46b8b6a1033397a700bf
institution Kabale University
issn 2045-2322
language English
publishDate 2025-07-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj-art-a4c6ec52f72c46b8b6a1033397a700bf2025-08-20T03:46:01ZengNature PortfolioScientific Reports2045-23222025-07-0115111510.1038/s41598-025-10136-5Artificial intelligence–based diabetes risk prediction from longitudinal DXA bone measurementsSulaiman Khan0Zubair Shah1College of Science and Engineering, Hamad Bin Khalifa University, Qatar FoundationCollege of Science and Engineering, Hamad Bin Khalifa University, Qatar FoundationAbstract Diabetes mellitus (DM) is a serious global health concern that poses a significant threat to human life. Beyond its direct impact, diabetes substantially increases the risk of developing severe complications such as hypertension, cardiovascular disease, and musculoskeletal disorders like arthritis and osteoporosis. The field of diabetes classification has advanced significantly with the use of diverse data modalities and sophisticated tools to identify individuals or groups as diabetic. But the task of predicting diabetes prior to its onset, particularly through the use of longitudinal multi-modal data, remains relatively underexplored. To better understand the risk factors associated with diabetes development among Qatari adults, this longitudinal research aims to investigate dual-energy X-ray absorptiometry (DXA)-derived whole-body and regional bone composition measures as potential predictors of diabetes onset. We proposed a case—control retrospective study, with a total of 1,382 participants contains 725 male participants (cases: 146, control: 579) and 657 female participants (case: 133, control: 524). We excluded participants with incomplete data points. To handle class imbalance, we augmented our data using Synthetic Minority Over-sampling Technique (SMOTE) and SMOTEENN (SMOTE with Edited Nearest Neighbors), and to further investigated the association between bones data features and diabetes status, we employed ANOVA analytical method. For diabetes onset prediction, we employed both conventional and deep learning (DL) models to predict risk factors associated with diabetes in Qatari adults. We used SHAP and probabilistic methods to investigate the association of identified risk factors with diabetes. During experimental analysis, we found that bone mineral density (BMD), bone mineral contents (BMC) in the hip, femoral neck, troch area, and lumbar spine showed an upward trend in diabetic patients with $$p-value \ge 0.001$$ . Meanwhile, we found that patients with abnormal glucose metabolism had increased wards BMD and BMC with low Z-score compared to healthy participants. Consequently, it shows that the diabetic group has superior bone health than the control group in the cohort, because they exhibit higher BMD, muscle mass, and bone area across most body regions. Moreover, in the age group distribution analysis, we found that the diabetes prediction rate was higher among healthy participants in the younger age group 20–40 years. But as the age range increased, the model predictions became more accurate for diabetic participants, especially in the older age group 56–69 years. It is also observed that male participants demonstrated a higher susceptibility to diabetes onset compared to female participants. Shallow models outperformed the DL models by presenting improved accuracy (91.08%), AUROC (96%), and recall values (91%). This pivotal approach utilizing DXA scans highlights significant potential for the rapid and minimally invasive early detection of diabetes.https://doi.org/10.1038/s41598-025-10136-5
spellingShingle Sulaiman Khan
Zubair Shah
Artificial intelligence–based diabetes risk prediction from longitudinal DXA bone measurements
Scientific Reports
title Artificial intelligence–based diabetes risk prediction from longitudinal DXA bone measurements
title_full Artificial intelligence–based diabetes risk prediction from longitudinal DXA bone measurements
title_fullStr Artificial intelligence–based diabetes risk prediction from longitudinal DXA bone measurements
title_full_unstemmed Artificial intelligence–based diabetes risk prediction from longitudinal DXA bone measurements
title_short Artificial intelligence–based diabetes risk prediction from longitudinal DXA bone measurements
title_sort artificial intelligence based diabetes risk prediction from longitudinal dxa bone measurements
url https://doi.org/10.1038/s41598-025-10136-5
work_keys_str_mv AT sulaimankhan artificialintelligencebaseddiabetesriskpredictionfromlongitudinaldxabonemeasurements
AT zubairshah artificialintelligencebaseddiabetesriskpredictionfromlongitudinaldxabonemeasurements