Role of TyG, TyG-BMI and METS-IR in osteoporosis risk among older men: a retrospective cohort study.

Background and objectives: Obese and diabetic individuals tend to have insulin resistance, but are less like-ly to develop osteoporosis. The association of triglyceride-glucose (TyG) related indices with osteoporosis remains controversial, and longitudinal evidence exploring the male osteoporosis (MOP) is limited. This study aims to examine TyG, TyG-body mass index (TyG-BMI) and the metabolic score for insulin resistance (METS-IR) with osteoporosis risk among older men.

Methods and study design: A cohort study based on 1622 middle-aged and older men in 2015 was conducted, and followed up until 2022. Participants with oste-oporosis and admittedly secondary risk factors were excluded. TyG, TyG-BMI, METS-IR and corresponding quantiles were calculated. Cox proportional hazard regression models were used to assess the hazard ratios (HRs) and 95% confidence interval (CI). Receiver operating characteristic (ROC) curve was applied to estimate their performance in osteoporosis screening.

Results: 72 of 1622 participants were newly developed OP during the 9317 person-years. The adjusted HRs of TyG, TyG-BMI, and METS-IR for MOP were 0.573 (95%CI 0.336-0.976), 0.991 (95%CI 0.984-0.999) and 0.929 (95%CI 0.892-0.968), respectively, and pre-sented at linear dose-response relationships. Subgroup analysis showed that the estimated benefit for MOP incidence was consistent among participants aged more than 70 years and related to BMI and eating mount of milk, fresh fruit and vegetables. No difference was found in the area under ROC curve for screening osteo-porosis, ranging from 0.585 to 0.617.

Conclusions: TyG and relevant indices were associated with the inci-dence of osteoporosis in the senile men, and the relationship was thought to correlate with BMI and nutritional behaviors.