Testosterone is an independent determinant of bone mineral density in men with type 2 diabetes mellitus

Abstract

Background: Although many reports have elucidated pathophysiological characteristics of abnormal bone metabolism in patients with type 2 diabetes mellitus (DT2), determinants of bone mineral density (BMD) in patients with DT2 are still controversial.

Methods: We examined 168 Belarussian men 45–60 years of age. Plasma total cholesterol (TC), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol, triglycerides, hemoglobin A_1c (HbA_1c), immunoreactive insulin, and C-reactive protein concentrations were assessed. BMD was measured using dual energy X-ray densitometry of the lumbar spine (L₁–L₄). Total testosterone (TT) and sex hormone-binding globulin were measured, and free testosterone (FT) was calculated.

Results: Using univariate linear regression analysis, BMD of the lumbar spine was significantly correlated with FT (r=0.32, p<0.01) and TT (r=0.36, p<0.01). Using multiple linear regression analysis adjusted for confounding factors, BMD was significantly correlated with TT (β=0.23, p<0.001) and TC (β=–0.029, p=0.005). Age (β=0.005, p=0.071), body mass index (β=0.005, p=0.053), HbA_1c (β=–0.002, p=0.72) and duration of diabetes (β=0.001, p=0.62) were not significantly correlated with BMD.

Conclusions: Our data indicate that androgens are independent determinants of BMD in male patients with DT2.