{"title":"Weight-adjusted waist index is associated with risk of poor bone quality rather than low bone mass in patients with type 2 diabetes.","authors":"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","doi":"10.1186/s13098-025-01740-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":11106,"journal":{"name":"Diabetology & Metabolic Syndrome","volume":"17 1","pages":"177"},"PeriodicalIF":3.4000,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121163/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetology & Metabolic Syndrome","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13098-025-01740-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
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.
期刊介绍：
Diabetology & Metabolic Syndrome publishes articles on all aspects of the pathophysiology of diabetes and metabolic syndrome.
By publishing original material exploring any area of laboratory, animal or clinical research into diabetes and metabolic syndrome, the journal offers a high-visibility forum for new insights and discussions into the issues of importance to the relevant community.
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