ESPE Abstracts

Aim: Insulin resistance is known to be closely related to the development of obesity and type 2 diabetes, whereas transient insulin resistance is part of the physiological developmental processes during pubertal years. However, insulin resistance might have detrimental effect on growing bone and bone mineral accrual. The aim of the present study was to identify whether increase in insulin resistance during pubertal years contribute to bone mineral characteristics in young adult males independently of body composition parameters.

Methods: Data from 85 boys were included into this retrospective cohort-based longitudinal observational study. Boys were studied annually during their pubertal years (12 years at baseline) and at follow-up at the age of 18 years. Anthropometry, bone age, fasting blood samples, body composition, and total body and lumbar spine bone mineral characteristics were measured. Insulin resistance was determined by homeostatic model assessment of insulin resistance (HOMA-IR). To determine the effect of changes in HOMA-IR during pubertal years as longitudinal predictor to fixed bone mineral outcome variables at the age of 18 years, multiple regression analyses with were performed. All models were adjusted to potential confounding variables.

Results: Increment in HOMA-IR was negative independent predictor of lumbar spine bone mineral areal density (β = -0.202, P=0.005) and lumbar spine bone mineral apparent density (β = -0.235, P=0.005) after adjustment to body composition related and other justified confounding variables.

Conclusions: Increment in insulin resistance during pubertal years has potential detrimental effect on lumbar spine bone mineral density accrual independently of body composition parameters. Further studies are necessary to clarify whether monitoring HOMA-IR through puberty may identify subjects having increased risk for low peak bone mass and possible osteoporosis in future.