title: Heel bone strength is related to lifestyle factors in Okinawan men with type 2 diabetes mellitus.
abstract: OBJECTIVE
  Although male diabetic patients have an increased risk of fracture, there is little information about this in the literature. The association between heel bone stiffness and the lifestyle of male patients with diabetes was evaluated.
  
  
  METHODS
  The study included 108 participants with type 2 diabetes mellitus patients and 168 age-adjusted, healthy male volunteers. None of the participants had a history of osteoporosis or other severe diseases. Heel bone stiffness was examined by quantitative ultrasound, and each participant completed a health interview survey questionnaire. Bone stiffness was taken as an indicator of bone strength. Stepwise regression analysis was used to investigate associations between bone stiffness and lifestyle-related factors, such as sunlight exposure, intake of milk or small fish, regular exercise, cigarette smoking, consumption of alcohol, and number of remaining teeth.
  
  
  RESULTS
  Bone stiffness showed a significant negative association with cigarette smoking [standardized coefficient (SC) = -0.297, F-value (F) = 10.059] and age (SC = -0.207, F = 7.565) in diabetic patients. Bone stiffness showed a significant negative association with age (SC = -0.371, F = 12.076) and height (SC = -0.193, F = 7.898), as well as a significant positive association with sunlight exposure (SC = 0.182, F = 9.589) and intake of small fish (SC = 0.170, F = 7.393) in controls.
  
  
  CONCLUSIONS
  These findings suggest that cigarette smoking and age are negatively associated with bone stiffness in Okinawan male patients with type 2 diabetes mellitus.
authors: Departments of Maternal and Child Nursing, School of Health Sciences, Faculty of Medicine, Graduate school of Medicine, University of the Ryukyus Okinawa, Japan.
authors: Michiko
authors: M
authors: Gushiken
authors: Department of Community Healthcare System, Graduate school of Medicine, University of the Ryukyus Okinawa, Japan.
authors: Ichiro
authors: I
authors: Komiya
authors: Department of Clinical Pharmacology and Therapeutics, Graduate school of Medicine, University of the Ryukyus Okinawa, Japan.
authors: Shinichiro
authors: S
authors: Ueda
authors: Departments of Maternal and Child Nursing, School of Health Sciences, Faculty of Medicine, Graduate school of Medicine, University of the Ryukyus Okinawa, Japan.
authors: Jun
authors: J
authors: Kobayashi
keywords: Heel bone stiffness; Male; Type 2 diabetes mellitus