Relationships among biological sex, body composition, and bone mineral density in young persons with and without diabetes.

Abstract

Objectives: Bone mineral density (BMD) is influenced by factors including age, sex, body composition, and diabetes. However, data regarding these relationships in young individuals is limited. The objective of this study was to address this gap in the literature.

Methods: We conducted a post-hoc analysis of participants from six cross-sectional cohort studies, encompassing individuals with type 1 diabetes (T1D) and type 2 diabetes (T2D), as well as controls of healthy weight (HWC) and with obesity (OC). Whole-body dual-energy X-ray absorptiometry (DXA) was employed to measure BMD and body composition. Multiple linear regression models assessed sexual dimorphism in BMD, adjusting for age and exploring effect modification by group and sex.

Results: A total of 325 participants were included (T1D [n=123, mean age 22.4 years, 50 % male], T2D [n=72, mean age 16.2 years, 33 % male], HWC [n=79, mean age 16.6 years, 41 % male], and OC [n=51, mean age 13.8 years, 53 % male]). Sexual dimorphism in BMD was evident only in T1D and HWC, with males having higher BMD than females (p=0.021; p<0.001, respectively). BMI was positively correlated with BMD in all groups (p<0.001 for HWC; p=0.001 for OC; p<0.001 for T1D; p=0.008 for T2D). Body fat percentage was inversely correlated with BMD in HWC and T1D (p<0.001; p=0.011, respectively), but not in OC or T2D. Additionally, lean mass percentage was significantly associated with higher BMD in HWC and OC (p<0.001; p=0.023, respectively), but not in groups with diabetes.

Conclusions: Our study documents sexual dimorphism in BMD in youth, with varied associations between body composition metrics and BMD across groups with diabetes and in controls without diabetes, underscoring the importance of understanding these relationships for optimizing bone health during adolescence.