Insulin resistance in younger men linked to smaller bone size

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  • A study of nondiabetic men at the age of peak bone mass found an independent and inverse association between insulin resistance and trabecular and cortical bone size.

Why this matters

  • A mechanism linking insulin resistance to bone geometry might help explain elevated fracture risk in type 2 diabetes despite normal areal bone mineral density.

Study design

  • Cross-sectional sibling-pair population cohort study of 996 nondiabetic men aged 25-45 y evaluated for insulin resistance by homeostasis model assessment, with fasting blood glucose measurement and assessment of distal radius and the radial and tibial shaft by peripheral quantitative CT.
  • Funding: The Fund for Scientific Research–Flanders.

Key results

  • For both radial and tibial bone there were significant inverse relationships between insulin resistance and cortical area, trabecular area, periosteal circumference, and endosteal circumference, after adjusting for multiple confounders.


  • The hyperinsulinemic-euglycemic clamp technique, regarded as standard insulin sensitivity measure in research, was not used.