The associations between skeletal muscle mass to visceral fat area ratio (SVR) with bone mineral density (BMD) and 10-year probability of fracture risk in Chinese patients with type 2 diabetes mellitus (T2DM): a cross-sectional study.

Abstract

Introduction: Patients with type 2 diabetes mellitus (T2DM) have a higher risk of fracture, higher visceral fat, and lower muscle mass. The combined effect of skeletal muscle mass and visceral fat area [skeletal muscle mass to visceral fat area ratio (SVR)] on bone mineral density (BMD) and fracture risk in T2DM patients is still unknown.

Materials and methods: A cross-sectional study was performed on 422 patients. The associations between SVR with BMD and the 10-year probability of fractures [included major osteoporotic fracture (MOF), and hip fracture (HF)] were analyzed using R studio 4.2.3. Generalized additive models (GAMs) were used to identify the associations between SVR and BMD and fracture risk.

Results: There was a lower SVR in patients with osteoporosis/osteopenia than in controls. SVR was an independent determinant for BMD and MOF and HF, and SVR was positively associated with BMD and negatively associated with 10-year fracture risk in non-elderly men or elderly women with T2DM. SVR had an approximately positive linear association with BMD in elderly males and females, and it had an N-shaped curve association with BMD in non-elderly males. In addition, the associations between SVR and MOF/HF were negative linear in females and elderly men, and non-linear in non-elderly men.

Conclusion: Our study provided a novel viewpoint on the relationship between SVR and BMD/fracture risk. Relatively high SVR is a protective factor for bone in T2DM patients, but the osteoprotective effect of SVR was mediated by age and gender, and it persisted only in non-elderly men and elderly women with T2DM.