Lower bone turnover and relative bone deficits in men with metabolic syndrome: a matter of insulin sensitivity? The European Male Ageing Study

Laurent, M. R. et al. (2016) Lower bone turnover and relative bone deficits in men with metabolic syndrome: a matter of insulin sensitivity? The European Male Ageing Study. Osteoporosis International, 27(11), pp. 3227-3237. (doi: 10.1007/s00198-016-3656-x) (PMID:27273111)

Abstract

Introduction: Metabolic syndrome (MetS) has been associated with lower bone turnover and relative bone mass or strength deficits (i.e. not proportionate to body mass index, BMI), but the relative contributions of MetS components related to insulin sensitivity or obesity to male bone health remain unclear. Methods: We determined cross-sectional associations of MetS, its components and insulin sensitivity (by homeostatic model assessment-insulin sensitivity (HOMA-S)) using linear regression models adjusted for age, centre, smoking, alcohol, and BMI. Bone turnover markers and heel broadband ultrasound attenuation (BUA) were measured in 3129 men aged 40–79. Two centres measured total hip, femoral neck, and lumbar spine areal bone mineral density (aBMD, n = 527) and performed radius peripheral quantitative computed tomography (pQCT, n = 595). Results: MetS was present in 975 men (31.2 %). Men with MetS had lower β C-terminal cross-linked telopeptide (β-CTX), N-terminal propeptide of type I procollagen (PINP) and osteocalcin (P < 0.0001) and higher total hip, femoral neck, and lumbar spine aBMD (P ≤ 0.03). Among MetS components, only hypertriglyceridaemia and hyperglycaemia were independently associated with PINP and β-CTX. Hyperglycaemia was negatively associated with BUA, hypertriglyceridaemia with hip aBMD and radius cross-sectional area (CSA) and stress–strain index. HOMA-S was similarly associated with PINP and β-CTX, BUA, and radius CSA in BMI-adjusted models. Conclusions: Men with MetS have higher aBMD in association with their greater body mass, while their lower bone turnover and relative deficits in heel BUA and radius CSA are mainly related to correlates of insulin sensitivity. Our findings support the hypothesis that underlying metabolic complications may be involved in the bone’s failure to adapt to increasing bodily loads in men with MetS.

• Item Type: Articles
• Additional Information: The European Male Ageing Study was funded by the Commission of the European Communities Fifth Framework Programme, Quality of Life and Management of Living Resources, Grant QLK6-CT-2001-00258, by Arthritis Research UK, by the Research Foundation Flanders grants G.0171.03 and G.0854.13N and KU Leuven grant GOA/15/017. This report includes independent research supported by the UK National Institute for Health Research Biomedical Research Unit Funding Scheme. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health. The work of K.A.W. was conducted within the core programme of the MRC Nutrition and Bone Health Group at MRC Human Nutrition Research, funded by the UK Medical Research Council (Programme number U105960371). M.R.L. is a PhD Fellow of the Research Foundation Flanders. D.V. is a senior clinical investigator supported by the Clinical Research Fund of the University Hospitals Leuven, Belgium.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Lean, Professor Michael
• Authors: Laurent, M. R., Cook, M. J., Gielen, E., Ward, K. A., Antonio, L., Adams, J. E., Decallonne, B., Bartfai, G., Casanueva, F. F., Forti, G., Giwercman, A., Huhtaniemi, I. T., Kula, K., Lean, M.E.J., Lee, D. M., Pendleton, N., Punab, M., Claessens, F., Wu, F. C. W., Vanderschueren, D., Pye, S. R., and O’Neill, T. W.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Osteoporosis International
• Publisher: Springer
• ISSN: 0937-941X
• ISSN (Online): 1433-2965
• Published Online: 07 June 2016
• Copyright Holders: Copyright © International Osteoporosis Foundation and National Osteoporosis Foundation 2016
• First Published: First published in Osteoporosis International 27(11):3227-3237
• Publisher Policy: Reproduced in accordance with the publisher copyright policy