Differences in Skeletal and Non-skeletal Factors in a Diverse Sample of Men with and Without Type 2 Diabetes Mellitus

Aims: Patients with type 2 diabetes mellitus (T2DM) have increased fracture risk yet higher bone mineral density (BMD), but data are inconsistent in men. We compared skeletal and non-skeletal (e.g., muscle mass, strength) factors in men with/without T2DM.

Methods: Cross-sectional study of 1137 Boston men 30-79years in the Boston Area Community Health/Bone Survey. Diabetes status was self-reported, and BMD and body composition were measured by DXA, and grip strength by hand dynamometer. Physical function was assessed by walking speed and chair stands. Multivariable linear regressions examined associations of T2DM with skeletal/non-skeletal factors.

Results: Mean age was 48years. The population was 24.6% Black, 13.0% Hispanic, and 62.4% White. Prevalence of T2DM was 12.5%; average disease duration was 7.4years. While subjects with T2DM did not differ in skeletal factors (e.g., BMD), they had significantly lower appendicular lean mass [mean difference (MD)=-1.04kg; standard error (SE)=0.50; p=0.04], arms lean mass (MD=-0.42kg; SE=0.15; p=0.006) and grip strength (MD=-3.02kg; SE=1.25; p=0.025) after adjustment for age, race/ethnicity, and BMI.

Conclusions: Men with T2DM have lower muscle mass and strength, but similar BMD, compared to their non-diabetic counterparts. These differences in non-skeletal factors might explain, at least in part, the higher incidence of falls and fractures observed in T2DM patients.