Association of insulin resistance with near peak bone mass in the femur and lumbar spine of Korean adults aged 25-35: The Korean National Health and Nutrition Examination Survey 2008-2010

Abstract

Objective: This study aimed to evaluate the relationship between insulin resistance and the bone mineral density (BMD) of femur and lumbar spine in Korean adults who are expected to exhibit near peak bone mass.

Methods: Data from the Korean National Health and Nutrition Examination Survey 2008-2010 were analyzed. A total of 2,750 participants aged 25-35 years were included. Insulin resistance was assessed using a homeostatic model assessment of insulin resistance (HOMA-IR) and serum fasting insulin.

Results: In a multivariate linear regression analysis, the HOMA-IR was significantly inversely associated with the BMD of the total hip (TH, β = -0.052, P = 0.002), femoral neck (FN, β = -0.072, P<0.001), femoral trochanter (FTr, β = -0.055, P = 0.003), femoral intertrochanter (FITr, β = -0.041, P = 0.015), and lumbar spine (LS, β = -0.063, P = 0.001) among all study subjects after adjustment for gender, age, height, weight, whole body fat mass percentage, systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, vitamin D, smoking, alcohol intake, physical activity, education level, and household income in both genders as well as labor, the use of oral contraceptives, and age at menarche in females. The serum fasting insulin was significantly inversely associated with the BMD of the TH (β = -0.055, P = 0.001), FN (β = -0.072, P<0.001), FTr (β = -0.055, P = 0.003), FITr (β = -0.045, P = 0.009), and LS (β = -0.064, P = 0.001) among all subjects in a multivariate linear regression analysis.

Conclusion: Our results suggest that insulin resistance may be independently and inversely associated with the near peak bone mass of the femur and lumbar spine.

Fig 1. Adjusted means for the bone mineral density (BMD) of the total hip, femoral neck, femoral trochanter, femoral intertrochanter, and lumbar spine according to the HOMA-IR quartiles in Korean males (n = 1,208) and females (n = 1,542).

The BMD values of the total hip, femoral neck, femoral trochanter, femoral intertrochanter, and lumbar spine were adjusted for age, height, weight, whole body fat percentage, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), vitamin D, smoking, alcohol intake, physical activity, education level, and household income in both genders as well as labor, the use of oral contraceptives (OCs), and age at menarche in females using an analysis of covariance (ANCOVA) according to the gender-specific HOMA-IR quartile. ^a; P<0.05, vs. first quartile, ^b; P<0.05, vs. second quartile, ^c; P<0.05, vs. third quartile. BMD, bone mineral density; HOMA-IR, homeostatic model assessment of insulin resistance.