title: Association between insulin resistance and bone mass in men.
abstract: BACKGROUND
  The association between insulin resistance and bone mass is still not clear.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the association between insulin resistance and bone mass.
  
  
  METHODS
  This was a cross-sectional survey of the nationally representative population.
  
  
  METHODS
  A total of 3113 men (aged ≥20 years) from the fourth Korean National Health and Nutrition Examination Survey of 2008-2009 were included.
  
  
  METHODS
  Bone mineral density (BMD) was measured using dual-energy x-ray absorptiometry. Osteopenia and osteoporosis were defined using the World Health Organization T score criteria. Fasting plasma insulin and glucose levels were measured, and insulin resistance was evaluated using the homeostasis model assessment-estimated insulin resistance (HOMA-IR) index.
  
  
  RESULTS
  Age-, height-, and weight-adjusted mean BMD values significantly decreased as quartiles of HOMA-IR and the fasting plasma insulin level increased (P for trends <.001). In multivariable logistic regression analyses, participants who had a higher HOMA-IR or fasting plasma insulin level had a higher odds ratio for osteoporosis/osteopenia. Interestingly, the association between fasting plasma insulin level and whole-body BMD differed by the degree of insulin resistance. In the lowest quartile of HOMA-IR, the fasting insulin level was positively associated with BMD. As insulin resistance increased, however, the fasting insulin level was inversely associated with BMD, and this relationship became more significant as the degree of insulin resistance increased.
  
  
  CONCLUSIONS
  In a nationally representative sample of Korean men, insulin resistance and the fasting plasma insulin level were inversely associated with bone mass. Further studies are required to confirm this association and reveal the underlying mechanisms.
authors.affiliation: Jangseong Public Health Center (D.S.), Jangseong, 515-800 South Korea; Department of Family Medicine (S.K.), Korea Cancer Center Hospital, Seoul 139-240, South Korea; Department of Family Medicine (K.H.K., S.M.P.) and Department of Biomedical Sciences (S.M.P.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-744, South Korea; and Department of Family Medicine (K.L.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do 463-707, South Korea.
authors.forename: Doosup
authors.initials: D
authors.lastname: Shin
authors.forename: Soyeun
authors.initials: S
authors.lastname: Kim
authors.forename: Kyae Hyung
authors.initials: KH
authors.lastname: Kim
authors.forename: Kiheon
authors.initials: K
authors.lastname: Lee
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Park
mesh_terms: D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000453:epidemiology / Q000378:metabolism; D001842:Bone and Bones / Q000000981:diagnostic imaging* / Q000378:metabolism; D003430:Cross-Sectional Studies; D005272:Femur Neck / Q000000981:diagnostic imaging; D006801:Humans; D007333:Insulin Resistance; D008161:Lumbosacral Region / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009929:Organ Size; D010024:Osteoporosis / Q000453:epidemiology / Q000378:metabolism; D011859:Radiography; D056910:Republic of Korea / Q000453:epidemiology