Weight-adjusted waist index is associated with risk of poor bone quality rather than low bone mass in patients with type 2 diabetes
Abstract Background Type 2 diabetes (T2D) correlates with an elevated risk of osteoporotic fractures. However, factors influencing bone mineral density (BMD) and trabecular bone score (TBS) in Chinese individuals with T2D remain unclear. This study aimed to investigate the clinical and biochemical d...
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BMC
2025-05-01
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| Series: | Diabetology & Metabolic Syndrome |
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| Online Access: | https://doi.org/10.1186/s13098-025-01740-6 |
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| author | Dehuai Feng Junying Liu Ningning Bai Shujuan Chen Liming Zhou Xinlian He Keli Zhao Shaobin Wang Jinyang Wan Sheng Ouyang Yiting Zheng Zhimao Cai Dewen Yan Ling Chen |
| author_facet | Dehuai Feng Junying Liu Ningning Bai Shujuan Chen Liming Zhou Xinlian He Keli Zhao Shaobin Wang Jinyang Wan Sheng Ouyang Yiting Zheng Zhimao Cai Dewen Yan Ling Chen |
| author_sort | Dehuai Feng |
| collection | DOAJ |
| description | Abstract Background Type 2 diabetes (T2D) correlates with an elevated risk of osteoporotic fractures. However, factors influencing bone mineral density (BMD) and trabecular bone score (TBS) in Chinese individuals with T2D remain unclear. This study aimed to investigate the clinical and biochemical determinants of BMD and TBS in patients with T2D, with a focus on elucidating the role of weight-adjusted waist index (WWI) in modulating bone mass and quality in this cohort. Methods Data of 161 women and 153 men with T2D collected between July 2022 and March 2023 in Shenzhen, China, were analyzed in our cross-sectional study. Lumbar spine BMD and TBS of all participants were obtained using dual-energy X-ray absorptiometry. WWI was defined as waist circumference over the square root of weight. Results Multivariate regression analysis demonstrated that lumbar spine TBS was inversely correlated with age, menopausal status, and WWI in women (p < 0.05). In men, TBS was negatively associated with age and WWI (p < 0.05). For women, glycated hemoglobin A1c positively influenced BMD (p < 0.05), whereas age, diabetic retinopathy, and N-mid osteocalcin were negatively associated. No significant predictors of BMD were identified in the male cohort. For predicting degraded TBS, the optimal WWI cut-offs were 11.257 cm/√kg (S: 61.1%, E: 80.7%) in males and 11.247 cm/√kg (S: 70.3%, E: 71.1%) in females. Conclusions Our findings highlight WWI as a novel and potentially more precise indicator of body fat, associated with diminished bone quality rather than solely low bone mass in patients with T2D in China. These results suggest that evaluating bone health in individuals with higher WWI may require more than just bone mass assessment. The results also suggest that the optimal WWI cut-off points for predicting degraded TBS are approximately 11.25 cm/√kg, highlighting thresholds for fracture risk. |
| format | Article |
| id | doaj-art-c8ac48aec34a405091be629f4ff81a0f |
| institution | OA Journals |
| issn | 1758-5996 |
| language | English |
| publishDate | 2025-05-01 |
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| series | Diabetology & Metabolic Syndrome |
| spelling | doaj-art-c8ac48aec34a405091be629f4ff81a0f2025-08-20T01:59:56ZengBMCDiabetology & Metabolic Syndrome1758-59962025-05-0117111010.1186/s13098-025-01740-6Weight-adjusted waist index is associated with risk of poor bone quality rather than low bone mass in patients with type 2 diabetesDehuai Feng0Junying Liu1Ningning Bai2Shujuan Chen3Liming Zhou4Xinlian He5Keli Zhao6Shaobin Wang7Jinyang Wan8Sheng Ouyang9Yiting Zheng10Zhimao Cai11Dewen Yan12Ling Chen13Department of Endocrinology, Shenzhen Second People’s Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen Clinical Research Center for Metabolic Diseases, Shenzhen Center for Diabetes Control and PreventionDepartment of Endocrinology, Shenzhen Second People’s Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen Clinical Research Center for Metabolic Diseases, Shenzhen Center for Diabetes Control and PreventionDepartment of Endocrinology, Shenzhen Second People’s Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen Clinical Research Center for Metabolic Diseases, Shenzhen Center for Diabetes Control and PreventionDepartment of Endocrinology, Shenzhen Second People’s Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen Clinical Research Center for Metabolic Diseases, Shenzhen Center for Diabetes Control and PreventionDepartment of Endocrinology, Shenzhen Second People’s Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen Clinical Research Center for Metabolic Diseases, Shenzhen Center for Diabetes Control and PreventionDepartment of Endocrinology, Shenzhen Second People’s Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen Clinical Research Center for Metabolic Diseases, Shenzhen Center for Diabetes Control and PreventionWestern Institute of Health Data ScienceCenter of Health Management, Peking University Shenzhen HospitalDepartment of Endocrinology, Shenzhen Second People’s Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen Clinical Research Center for Metabolic Diseases, Shenzhen Center for Diabetes Control and PreventionDepartment of Endocrinology, Shenzhen Second People’s Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen Clinical Research Center for Metabolic Diseases, Shenzhen Center for Diabetes Control and PreventionDepartment of Endocrinology, Shenzhen Second People’s Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen Clinical Research Center for Metabolic Diseases, Shenzhen Center for Diabetes Control and PreventionDepartment of General Medicine, Shenzhen Second People’s Hospital, the First Affiliated Hospital of Shenzhen UniversityDepartment of Endocrinology, Shenzhen Second People’s Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen Clinical Research Center for Metabolic Diseases, Shenzhen Center for Diabetes Control and PreventionDepartment of Endocrinology, Shenzhen Second People’s Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen Clinical Research Center for Metabolic Diseases, Shenzhen Center for Diabetes Control and PreventionAbstract Background Type 2 diabetes (T2D) correlates with an elevated risk of osteoporotic fractures. However, factors influencing bone mineral density (BMD) and trabecular bone score (TBS) in Chinese individuals with T2D remain unclear. This study aimed to investigate the clinical and biochemical determinants of BMD and TBS in patients with T2D, with a focus on elucidating the role of weight-adjusted waist index (WWI) in modulating bone mass and quality in this cohort. Methods Data of 161 women and 153 men with T2D collected between July 2022 and March 2023 in Shenzhen, China, were analyzed in our cross-sectional study. Lumbar spine BMD and TBS of all participants were obtained using dual-energy X-ray absorptiometry. WWI was defined as waist circumference over the square root of weight. Results Multivariate regression analysis demonstrated that lumbar spine TBS was inversely correlated with age, menopausal status, and WWI in women (p < 0.05). In men, TBS was negatively associated with age and WWI (p < 0.05). For women, glycated hemoglobin A1c positively influenced BMD (p < 0.05), whereas age, diabetic retinopathy, and N-mid osteocalcin were negatively associated. No significant predictors of BMD were identified in the male cohort. For predicting degraded TBS, the optimal WWI cut-offs were 11.257 cm/√kg (S: 61.1%, E: 80.7%) in males and 11.247 cm/√kg (S: 70.3%, E: 71.1%) in females. Conclusions Our findings highlight WWI as a novel and potentially more precise indicator of body fat, associated with diminished bone quality rather than solely low bone mass in patients with T2D in China. These results suggest that evaluating bone health in individuals with higher WWI may require more than just bone mass assessment. The results also suggest that the optimal WWI cut-off points for predicting degraded TBS are approximately 11.25 cm/√kg, highlighting thresholds for fracture risk.https://doi.org/10.1186/s13098-025-01740-6Weight-adjusted waist indexObeseTrabecular bone scoreType 2 diabetesBone fracture |
| spellingShingle | Dehuai Feng Junying Liu Ningning Bai Shujuan Chen Liming Zhou Xinlian He Keli Zhao Shaobin Wang Jinyang Wan Sheng Ouyang Yiting Zheng Zhimao Cai Dewen Yan Ling Chen Weight-adjusted waist index is associated with risk of poor bone quality rather than low bone mass in patients with type 2 diabetes Diabetology & Metabolic Syndrome Weight-adjusted waist index Obese Trabecular bone score Type 2 diabetes Bone fracture |
| title | Weight-adjusted waist index is associated with risk of poor bone quality rather than low bone mass in patients with type 2 diabetes |
| title_full | Weight-adjusted waist index is associated with risk of poor bone quality rather than low bone mass in patients with type 2 diabetes |
| title_fullStr | Weight-adjusted waist index is associated with risk of poor bone quality rather than low bone mass in patients with type 2 diabetes |
| title_full_unstemmed | Weight-adjusted waist index is associated with risk of poor bone quality rather than low bone mass in patients with type 2 diabetes |
| title_short | Weight-adjusted waist index is associated with risk of poor bone quality rather than low bone mass in patients with type 2 diabetes |
| title_sort | weight adjusted waist index is associated with risk of poor bone quality rather than low bone mass in patients with type 2 diabetes |
| topic | Weight-adjusted waist index Obese Trabecular bone score Type 2 diabetes Bone fracture |
| url | https://doi.org/10.1186/s13098-025-01740-6 |
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