INSULIN IS INVERSELY ASSOCIATED WITH BONE MASS ONLY IN INSULIN RESISTANT POPULATION: THE KOREA NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY 2008-2009

Presentation Number: SAT-258
Date of Presentation: June 15th, 2013

Yong Jun Choi*1, Ji In Lee2, Ji Hye Yim3, Dae-Jung Kim4, Yunwhan Lee5 and Yoon-Sok Chung6
1Ajou University Hospital, Suwon, Gyeonggi-do, Korea, Republic of (South), 2Ajou University School of Medicine, Suwon, Korea, Republic of (South), 3Ajou University School of Medicine, Korea, Republic of (South), 4Ajou Univ Sch of Med, Suwon, Korea, Republic of (South), 5Ajou University School of Medicine, 6Ajou Unversity School of Medicine, Suwon, Korea, Republic of (South)

Abstract

Background: Insulin has been known to be an important osteotropic hormone. However, it has been reported that the positive association has frequently become negative after adjustment for body mass index (BMI). In this study, we investigated whether insulin is associated with bone mass in Korean adults, and if so, whether this association is positive or negative. 

Methods: We used data from the fourth Korea National Health and Nutrition Examination Survey 2008–2009. The measurements of anthropometric parameters and bone mass were obtained using dual energy X-ray absorptiometry (DXA) (Discovery-W, Hologic Inc., USA). A total of 7,355 adults (3,345 men and 4,010 women) aged 30 or older had available data. Subjects were divided into three groups and separately analyzed based on sex and menopausal status (men, pre-, and postmenopausal women). Linear regression models were used to analyze relations between insulin and bone mass adjusted for age, household income, education, smoking, alcohol, 25-hydroxy vitamin D, height, weight, fat mass and the markers related to insulin resistance.

Results: After adjustment for confounding factors, there was an inverse association between insulin and total body bone mass [men: β= -0.112, P<0.001; premenopausal women: β= -0.075, P<0.001; postmenopausal women: β= -0.037, P=0.043]. In the stratified analysis, the association between insulin and bone mass was apparent only in individuals with the highest BMI tertile (men: β= -0.152, P<0.001; premenopausal women: β= -0.148, P<0.001; postmenopausal women: β= -0.157, P<0.001).

Conclusion: There was an inverse association between insulin and total body bone mass after adjustment of the confounding factors regardless of sex and menopausal status. However, this association was apparent only in the insulin resistant population. This strongly suggests that any adverse influence of insulin on bone mass is likely to reflect a role of other factors associated with insulin resistance rather than a direct action of insulin itself.

 

Nothing to Disclose: YJC, JIL, JHY, DJK, YL, YSC