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Diabetes Care, Vol 19, Issue 12 1388-1392, Copyright © 1996 by American Diabetes Association
Does hyperinsulinemia preserve bone?
E Barrett-Connor and D Kritz-Silverstein
Department of Family and Preventive Medicine, University of California, San Diego, La Jolla 92093-0607, USA. ebarrettconnor@ucsd.edu
OBJECTIVE: Obesity and NIDDM are each associated with increased bone
mineral density (BMD). We therefore hypothesize that hyperinsulinemia is an
osteogenic factor. RESEARCH DESIGN AND METHODS: Subjects consisted of 411
men and 559 women aged 50-89 years who were participants in the Rancho
Bernardo Heart and Chronic Disease Study and were not diabetic by history
or oral glucose tolerance test. Fasting and 2-h postchallenge insulin were
measured by radioimmunoassay. Bone mineral density was measured at the
midshaft radius with single photon absorptiometry and at the lumbar spine
and hip with dual energy X-ray absorptiometry. RESULTS: Multiple regression
analyses indicated that among men, a significant insulin-BMD association at
the hip was no longer apparent after adjusting for covariates. Among women,
fasting insulin was significantly and positively associated with bone
density of the radius and spine (P < 0.05), independent of age, BMI,
waist-hip ratio, postmenopausal estrogen use, age at menopause, thiazide
use, family history of diabetes, current cigarette smoking, and exercise.
Each 10 microU/ml increase in fasting insulin was associated with an
increase of 0.33 and 0.57 g/cm2 of the radius and spine, respectively.
CONCLUSIONS: Hyperinsulinemia may be responsible for part of the observed
association of both diabetes and obesity with BMD in women.

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Copyright © 1996 by the American Diabetes Association.
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