Specific higher levels of serum uric acid might have a protective effect on bone mineral density within a Chinese population over 60 years old: a cross-sectional study from northeast China

Low serum 25-hydroxy-vitamin D levels are associated with metabolic syndrome in a representative community population from Macau, China

Asians, especially Chinese have an increasingly high prevalence of vitamin D deficiency and insufficiency (serum 25-hydroxy-vitamin D 25(OH)D < 30 nmol/L and < 50 nmol/L, respectively). This population group also has a high prevalence of cardiometabolic risk factors such as Myocardial Infarction (MI), Metabolic Syndrome (MetS) and low blood levels of high-density lipoproteins (HDL) and high blood levels of triglycerides (TG). The aim of this analysis was to investigate these associations in a population from Macau, China. Blood, anthropometric, and physical data were collected from 1410 randomly selected residents of Macau. In this population, (55 % female, 19-89 years) 54 % were vitamin D insufficient. Results from categorical multivariate regression analyses (adjusted for age, sex, and physical activity, sitting and sunlight exposure) indicated significant two-fold associations between vitamin D insufficiency and prevalence of MI, MetS and low HDL and high TG levels. These associations became stronger when investigated with vitamin D deficiency (25(OH)D < 30 nmol/L). The association between cardiometabolic factors and vitamin D deficiency in those older (≥60 yrs) increased markedly to OR MI= 9.48 (2.62-34.32), OR MetS= 7.82 (3.31-18.46) and OR low HDL= 8.68 (1.56-21.16) and OR high TG= 2.37 (1.07-5.25). These interesting observational findings suggest high vulnerability to lower 25(OH)D levels with related health disparities affecting older Asians. Integration of public health measures to detect vitamin D deficiency and insufficiency in Macau is important, and we suggest that routine health screening including serum 25(OH)D, HDL and TG in China may be protective for those at higher risk for related cardiometabolic conditions.

Uric Acid Correlates with Serum Levels of Mineral Bone Metabolism and Inflammation Biomarkers in Patients with Stage 3a-5 Chronic Kidney Disease

Background and Objectives: Uric acid (UA) and the markers of mineral bone metabolism and inflammation are commonly altered in patients with chronic kidney disease (CKD) and are associated with the risk of cardiovascular complications and death. Studies point to a link between high serum UA and mineral bone homeostasis and inflammation, but controversy remains. The aim of this study was to evaluate the relationship between UA levels and mineral bone metabolism and inflammation biomarkers in a sample of Mexican patients with CKD 3a-5. Materials and Methods: This cross-sectional study included 146 Mexican patients with CKD 3a-5. In addition, 25 healthy subjects were included in the study with the aim of generating reference data for comparisons. Metabolic parameters including UA serum concentrations, mineral bone metabolism (parathormone (PTH), fibroblast growth factor 23 (FGF23), calcium, and phosphate), and inflammation (interleukin (IL)-1β, IL-6, and tumor necrosis factor-alpha (TNF-α)) biomarkers were measured in all of the samples and compared as a function of the estimated glomerular function rate (eGFR) or UA levels. Results: Intact PTH, FGF23, and cytokines were higher in advanced CKD stages. Patients with hyperuricemia had significantly higher values of FGF23 and TNF-α compared with those without hyperuricemia. The eGFR was found to be significantly and negatively correlated with all markers. Uric acid was significantly correlated with phosphate, iPTH, FGF23, and TNF-α, whereas iPTH was significantly correlated with FGF23, TNF-α, and FGF23. Finally, a multivariate analysis confirmed the relationship of eGFR with all the tested biomarkers, as well as other relationships of iPTH with UA and TNF-α and of FGF23 with UA and TNF-α. Conclusions: This study supports the relationship between uric acid and levels of mineral bone metabolism and inflammation biomarkers in patients with CKD at middle to advanced stages. In the follow-up of patients with CKD, monitoring and controlling UA levels through nutritional or pharmacological interventions could help in the prevention of alterations related to mineral bone metabolism.

Lacto-ovo-vegetarian diet is inversely associated with the osteosarcopenia in older adults

OBJECTIVE

Osteosarcopenia adversely affects the quality of life and physical health of older adults. We sought to explore the association between dietary patterns and osteosarcopenia in community-dwelling older adults.

METHODS

This is a cross-sectional study from Northeast China, in which, we included older community adults aged 60 and above. Through face-to-face interviews, we collected dietary information from participants using a food frequency questionnaire. Subsequently, principal component analysis (PCA) was used to obtain the dietary patterns of the participants. Through physical examination, we obtained the participants' information on osteosarcopenia, which was defined by the coexist of osteopenia and sarcopenia. We analysed the association between dietary patterns and dietary compositions with ostesarcopenia.

RESULTS

In this study, a total of 9429 participants were included, and the prevalence of osteosarcopenia in community-dwelling older adults was 6.2%. PCA identified three main dietary patterns, and the lacto-ovo-vegetarian dietary pattern was inversely associated with osteosarcopenia. Compared to the lowest lacto-ovo-vegetarian quartile (Q1), the Q4 group (OR = 0.64, 95% CI:0.49-0.83) was inversely associated with osteosarcopenia. Through the weighted quantile sum regression model, we also found that the overall effect of the lacto-ovo-vegetarian dietary components was inversely associated with osteosarcopenia (OR = 0.58, 95% CI: 0.37-0.92); the largest contributors were vegetables, fresh milk, eggs, and dairy products.

CONCLUSION

Overall, we found that a lacto-ovo-vegetarian dietary pattern, particularly the consumption of vegetables, fresh milk, eggs, and dairy products, was inversely associated with osteosarcopenia in older adults. And this might provide new insights for the prevention and treatment of osteosarcopenia.

Cross-sectional analysis of the correlation between serum uric acid and trabecular bone score: NHANES 2005-2008

Serum uric acid (SUA) has been discovered to be associated with bone mineral density (BMD), but its relationship with trabecular bone score (TBS) remains unclear. Thus, the aim of our study was to investigate the association between SUA levels and TBS. Our study included 5895 individuals over 20 years old (3061 men and 2834 women) from NHANES 2005-2008. To analyze the association between SUA and TBS, multivariate linear regression models with covariate adjustments were applied. Furthermore, population description, stratified analysis, single factor analysis, smooth curve fitting, interaction analysis, and threshold effect and saturation effect analysis were also conducted. After adjusting for covariates, SUA showed a strong negative relationship with total TBS (β = 0.319; 95% CI 0.145-0.494; P < 0.001). The relationship between SUA levels and total TBS was found to be nonlinear, with inflection points at 4.8 mg/dL for the overall population, 4.2 mg/dL for women, and 5.7 mg/dL for non-Hispanic whites, indicating a saturation effect. Additionally, no interactions were found in any of the subgroups. Our study found a negative association between SUA and total TBS in adults. Maintaining SUA at a saturated level can benefit in preventing osteoporosis and fractures.

Relationship between serum uric acid levels and osteoporosis

Osteoporosis (OP) is a systemic bone disease in which bone density and quality decrease and bone fragility increases due to a variety of causes, making it prone to fractures. The development of OP is closely related to oxidative stress. Uric acid (UA) is the end product of purine metabolism in the human body. Extracellular UA has antioxidant properties and is thought to have a protective effect on bone metabolism. However, the process of UA degradation can lead to intracellular oxidative stress, which together with UA-induced inflammatory factors, leads to increased bone destruction. In addition, UA can inhibit vitamin D production, resulting in secondary hyperparathyroidism and further exacerbating UA-associated bone loss. This review summarizes the relationship between serum UA levels and bone mineral density, bone turnover markers, and so on, in the hope of providing new insights into the pathogenesis and treatment of OP.

Association of serum uric acid levels with bone mineral density and the presence of osteoporosis in Chinese patients with Parkinson's disease: a cross-sectional study

INTRODUCTION

As the population ages, the incidence of osteoporosis among patients suffering from Parkinson's disease (PD) will surge continually, and the ensuing disability from falls is becoming a serious social burden. Due to its antioxidant properties, much literature has indicated the possible ability of serum uric acid (UA) to prevent ageing-related diseases caused by oxidative stress, including osteoporosis and PD. Therefore, this study was for exploring the connection of serum UA levels with bone mineral density (BMD) and the osteoporosis presence in Chinese PD patients.

MATERIALS AND METHODS

A cross-sectional design was used to statistically analyze 42 clinical parameters obtained from 135 patients with PD treated in Wuhan Tongji Hospital during 2020-2022. Multiple stepwise linear regression and multiple logistic regression analyses were constructed for identifying the association of serum UA levels with BMD as well as osteoporosis in PD patients, respectively. With receiver operative characteristic (ROC) curves, the optimal cutoff value was acquired for serum UA in the diagnosis of osteoporosis.

RESULTS

According to the regression analysis adjusted for confounders, serum UA levels in PD patients had positive correlation with BMD at each site and negative correlation with the presence of osteoporosis (P < 0.05 for all). ROC curves determined that the optimal cutoff value for UA to perform well in diagnosing osteoporosis in PD patients was 284.27 μmol/L (P < 0.001).

CONCLUSION

Relatively higher serum UA levels in the physiological range can work as a biomarker of higher BMD, and were strongly linked to lower prevalence of osteoporosis in Chinese PD patients.

Association between serum uric acid levels and bone mineral density in patients with osteoporosis: a cross-sectional study

BACKGROUND

The results of studies exploring the association between serum uric acid (SUA) and bone mineral density (BMD) have been controversial and inconsistent. We thus sought to explore whether SUA levels were independently associated with BMD in patients with osteoporosis (OP).

METHODS

This cross-sectional analysis was conducted using prospectively obtained data from the Affiliated Kunshan Hospital of Jiangsu University database pertaining to 1,249 OP patients that were hospitalized from January 2015 - March 2022. BMD was the outcome variable for this study, while baseline SUA levels were the exposure variable. Analyses were adjusted for a range of covariates including age, gender, body mass index (BMI) and a range of other baseline laboratory and clinical findings.

RESULTS

SUA levels and BMD were independently positively associated with one another in OP patients. Following adjustment for age, gender, BMI, blood urae nitrogen (BUN), and 25(OH)D levels, a 0.0286 g/cm² (β, 0.0286; 95% confidence interval [CI], 0.0193-0.0378, P < 0.000001) increase in BMD was observed per 100 μmol/L rise in SUA levels. A non-linear association between SUA and BMD was also observed for patients with a BMI < 24 kg/m², with a SUA level inflection point at 296 μmol/L in the adjusted smoothed curve.

CONCLUSIONS

These analyses revealed SUA levels to be independently positively associated with BMD in OP patients, with an additional non-linear relationship between these two variables being evident for individuals of normal or low body weight. This suggests that SUA levels may exert a protective effect on BMD at concentrations below 296 μmol/L in normal- and low-weight OP patients, whereas SUA levels above this concentration were unrelated to BMD.

Relationship between bone mineral density and hyperuricemia in obesity: A cross-sectional study

BACKGROUND

Obesity is an increasingly severe global public health issue. This study aims to estimate the cross-sectional association between bone mineral density (BMD) and hyperuricemia (HU) in obesity.

METHOD

A total of 275 obese subjects (126 men and 149 women) participated in this cross-sectional study. Obesity was diagnosed as body mass index (BMI) ≥28 kg/m2, whereas HU was defined as the blood uric acid level of 416 μmol/L in men and 360 μmol/L in women. The BMD of the lumbar spine and right hip was measured by dual-energy X-ray absorptiometry (DXA). The multivariable logistic regressions were employed to examine the relationship between BMD and HU in obesity, with the adjustment of gender, age, fasting blood glucose, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, creatinine, blood urea nitrogen, high-sensitivity C-reactive protein (hs-CRP), cigarette smoking, and alcohol drinking status.

RESULT

The overall prevalence of HU was 66.9% in this obese population. The mean age and BMI of this population were 27.9 ± 9.9 years and 35.2 ± 5.2 kg/m2, respectively. The multivariable-adjusted OR (the highest vs. lowest BMD quartile) demonstrated a negative relationship between BMD and HU in total (OR = 0.415, 95%CI: 0.182-0.946; p = 0.036), L1 (OR = 0.305, 95%CI: 0.127-0.730; p = 0.008), L2 (OR = 0.405, 95%CI: 0.177-0.925; p = 0.032), and L3 (OR = 0.368, 95%CI: 0.159-0.851; p = 0.020) lumbar vertebrae. In the subgroup analysis for the male population, the BMD was also negatively associated with HU in total (OR = 0.077, 95%CI: 0.014-0.427; p = 0.003), L1 (OR = 0.019, 95%CI: 0.002-0.206; p = 0.001), L2 (OR = 0.161, 95%CI: 0.034-0.767; p = 0.022), L3 (OR = 0.186, 95%CI: 0.041-0.858; p = 0.031), and L4 (OR = 0.231, 95%CI: 0.056-0.948; p = 0.042) lumbar vertebrae. However, such findings did not exist in women. In addition, there was no significant relationship between hip BMD and HU in obesity.

CONCLUSION

Our results showed that the lumbar BMD was negatively associated with HU in obesity. However, such findings only existed in men, rather than women. In addition, no significant relationship between hip BMD and HU existed in obesity. Due to the limited sample size and nature of the cross-sectional design, further large prospective studies are still needed to clarify the issues.

Nur77 Prevents Osteoporosis by Inhibiting the NF-κB Signalling Pathway and Osteoclast Differentiation

Inflammation is a major risk factor for osteoporosis, and reducing inflammatory levels is important for the prevention of osteoporosis. Although nuclear receptor 77 (Nur77) protects against inflammation in a variety of diseases, its role in osteoporosis is unknown. Therefore, the main purpose of this study was to investigate the osteoprotective and anti‐inflammatory effects of Nur77. The microCT and haematoxylin and eosin staining results indicated that knockout of Nur77 accelerated femoral bone loss in mice. The enzyme‐linked immunosorbent assay (ELISA) results showed that knockout of Nur77 increased the serum levels of hsCRP and IL‐6. The expression levels of NF‐κB, IL‐6, TNF‐α and osteoclastogenesis factors (TRAP, NFATC1, Car2, Ctsk) in the femurs of Nur77 knockout mice were increased significantly. Furthermore, in vitro, shNur77 promoted the differentiation of RAW264.7 cells into osteoclasts by activating NF‐κB, which was confirmed by PDTC treatment. Mechanistically, Nur77 inhibited osteoclast differentiation by inducing IκB‐α and suppressing IKK‐β. In RAW264.7 cells, overexpression of Nur77 alleviated inflammation induced by siIκB‐α, while siIKK‐β alleviated inflammation induced by shNur77. Consistent with the in vivo studies, we found that compared with control group, older adults with high serum hsCRP levels were more likely to suffer from osteoporosis (OR = 1.76, p < 0.001). Our data suggest that Nur77 suppresses osteoclast differentiation by inhibiting the NF‐κB signalling pathway, strongly supporting the notion that Nur77 has the potential to prevent and treat osteoporosis.

No association between serum uric acid and lumbar spine bone mineral density in US adult males: a cross sectional study

Available evidence linking serum uric acid (SUA) and bone mineral density (BMD) remains controversial, and data on this association are limited among adult men in the general population. Thus, the aim of this study was to evaluate the association of SUA with lumbar spine BMD in US adult males. A cross-sectional study was conducted based on the National Health and Nutrition Examination Survey (NHANES, 1999–2006) database. Multivariate linear regression analyses were employed to assess the association of SUA with lumbar spine BMD, considering complex survey design and sampling weights. Through rigorous eligibility criteria, a total of 6704 individuals were yielded for final data analysis (average age, 40.5 years; 70.6% white). After fully adjusting potential confounders, no associations were detected between SUA and lumbar spine BMD [β (95% confidence interval, CI), − 0.003 (− 0.007, 0.002)]. Additionally, similar results were observed in all stratification analyses, and no interactions were found based on all priori specifications. In brief, our findings did not provide an inspiring clue for the hypothesis that SUA may be beneficial to lumbar spine BMD. Future more prospective studies are needed to further explore the causal relationship of SUA with lumbar spine BMD.

Association between higher serum uric acid levels within the normal physiological range and changes of lumbar spine bone mineral density in healthy Chinese postmenopausal women: a longitudinal follow-up study

OBJECTIVES

The aim of this study was to investigate whether higher serum uric acid (SUA) levels within the physiological range were associated with changes in lumbar spine bone mineral density (LBMD) in postmenopausal women without existing lumbar spine osteoporosis after a longitudinal follow-up of 3.09 years, and to further confirm the relationship between SUA and bone mineral density (BMD) in other sites such as femoral neck, total hip, and trochanter at follow-up.

METHODS

A longitudinal study of 175 healthy postmenopausal women without osteoporosis was conducted in Shenyang, China. BMD of the lumbar spine, femoral neck, total hip, and trochanter were measured using dual-energy x-ray absorptiometry at each visit. Pearson's correlation analysis and regression analyses were performed to determine any associations.

RESULTS

There were positive correlations between baseline SUA and BMD of the lumbar spine (P = 0.03), total hip (P = 0.04), and trochanter (P = 0.04). Moreover, higher baseline SUA levels were independently associated with LBMD decline and the odds ratio of the baseline SUA of the third quartile group was 0.12 (95% confidence interval, 0.02-0.70, P < 0.05), with P = 0.23 for the trend in baseline SUA when compared with participants in the lowest, first quartile group after adjustment for many potential confounding variables.

CONCLUSIONS

Higher SUA levels within the normal physiological range were independently associated with decreased LBMD, and SUA levels were positively related to the BMD of the lumbar spine, total hip, and trochanter in healthy Chinese postmenopausal women.

Analyses of the relationship between hyperuricemia and osteoporosis

The aim of the present study was to evaluate the association between hyperuricemia and osteoporosis in a Korean population. Data from participants of the Korean Genome and Epidemiology Study who were ≥ 40 years old were collected from 2004 to 2016. Among 173,209 participants, 11,781 with hyperuricemia (> 7.0 mg/dL in men and > 6.0 mg/dL in women) and 156,580 controls were selected based on serum measurements. Odds ratios (ORs) of osteoporosis between individuals with hyperuricemia and controls were analyzed using a logistic regression model. In the adjusted model, age, sex, income group, body mass index, smoking, alcohol consumption, hypertension, diabetes mellitus, hyperlipidemia history and nutritional intake were adjusted. The adjusted OR (aOR) of osteoporosis was 0.79 [95% confidence interval (CI) = 0.71–0.87, P < 0.001]. In subgroup analyses according to age and sex, statistical significance was observed in men > 60 years old and in women > 50 years old. In another subgroup analysis according to past medical history, significant differences were found according to hypertension (aOR = 0.83, 95% CI = 0.73–0.94, and 0.75, 95% CI = 0.64–0.87), diabetes mellitus (aOR = 0.77, 95% CI = 0.69–0.86), and hyperlipidemia (aOR = 0.74, 95% CI = 0.61–0.89, and 0.81, 95% CI = 0.72–0.91). This study demonstrated that hyperuricemia was associated with a decreased risk of osteoporosis.

Advances in the occurrence and biotherapy of osteoporosis

Osteoporosis (OP) is a bone metabolic disease, is characterized by degeneration of bone structure and decreased bone mass. It happens in more than 1/3 women and 1/5 men of over than 50 years old, which affects the health and lives of people. The main mechanism of OP is mainly that the dynamic balance between the bone formation and resorption is broken, so that bone resorption is more than bone formation. It is prone to result in bone metabolism disorder. There are many precipitating factor such as elder age, low hormone level, genetic factors and bad hobbies. At the same time, the occurrence of the OP and its complications has different degrees of impact on people's quality of life. Based on the current understanding of the OP, we summarized the etiology, current clinical drugs and potential targeting therapy for OP. Although the research have made many progress in explore what is the novel mechanism and how to improve the effect, there are still many problems in the treatment method that limit its application prospects and need to be solved. In this review, we mainly focus on the mechanism of OP and related research on the targeted treatment of OP. Hopefully, our summary will provide a reference to develop some novel strategies for the target therapy of OP.

Correlation of oxidative stress-related biomarkers with postmenopausal osteoporosis: a systematic review and meta-analysis

Oxidative stress (OS) is implicated in postmenopausal osteoporosis (PO). Results show an imbalance between antioxidative and oxidative markers in PO. Thus, monitoring of OS-related biomarkers and keeping balance between reactive oxygen species and antioxidant system are beneficial to the diagnosis and prognosis of PO.

PURPOSE

Oxidative stress (OS) has been implicated in postmenopausal osteoporosis (PO). However, the relations between OS-related markers and PO are controversial. This study aimed to quantitatively and comprehensively assess the roles of OS-related biomarkers in PO.

METHODS

Relevant articles were retrieved from electronic databases. All OS-associated biomarkers with at least 2 independent study outcomes were meta-analyzed. The pooled standardized mean differences (SMD) with its 95% confidence intervals (CI) were presented.

RESULTS

A total of 36 studies involving 16 OS-related biomarkers were investigated. The overall results showed that total oxidant status (TOS), superoxide dismutase (SOD), hydroperoxides (HY), paraoxonase (PON1), nitric oxide (NO), and homocysteine (Hcy) were not statistically different between the PO and control groups, whereas significantly increased levels of oxidative stress index (OSI), malondialdehyde (MDA), advanced oxidation protein products (AOPP), and vitamin B12, along with decreased total antioxidant status (TAS), total antioxidant power (TAP), catalase (CAT), glutathione peroxidase (GPx), uric acid (UA), and folate, were detected in the PO group. Subgroup analysis based on biological samples displayed significantly elevated NO in erythrocyte and Hcy in serum, along with decreased SOD in serum.

CONCLUSION

Monitoring of certain OS-related biomarkers might be beneficial to the diagnosis and prognosis of PO.

Association of Serum Uric Acid Status With Bone Mineral Density in Adolescents Aged 12-19 Years

Aims: Evidence linking serum uric acid (sUA) and bone mineral density (BMD) in adolescents is very limited. To the best of our knowledge, only one report has focused on the relationship between sUA and BMD in adolescents. Thus, this study aimed to determine the association between sUA and total BMD in adolescents aged 12-19 years. Methods: A cross-sectional study was conducted on a sample composed of non-institutionalized US population from the National Health and Nutrition Examination Survey. Weighted multivariate linear regression models were used to evaluate the association between sUA and total BMD. Subgroup analyses were further performed. Results: sUA positively correlated with total BMD in the multiple regression model after adjusting for potential confounders. However, in the subgroup analyses stratified by sex, age, or race/ethnicity, the association between sUA and total BMD followed an inverted U-shaped curve in female adolescents, adolescents aged 16-19 years, and other race/ethnicity. Conclusions: Our results suggested that the correlation between sUA level and total BMD differed by sex. The increased sUA level would be beneficial to bone health in adolescents with low sUA levels, but for female adolescents, a higher sUA level (turning point, 3.9 mg/dL) may have an adverse effect on bone health.

The Association between Serum Uric Acid and Bone Mineral Density in Older Adults

OBJECTIVES

Uric acid has been found to be potentially protective in bone metabolism. We investigated the relationship between serum uric acid (sUA) and lumbar bone mineral density (BMD) among 4156 participants aged 60 years and over from the National Health and Nutrition Examination Survey (NHANES).

METHODS

To estimate the association between sUA and lumbar BMD, multivariate logistic regression analyses were conducted. Fitted smoothing curves and generalized additive models were also performed.

RESULTS

We found sUA positively correlated with lumbar BMD after adjusting for other confounders. On subgroup analyses, stratified by sex and race/ethnicity, the positive correlation of sUA with lumbar BMD remained in both men and women, as well as in whites and Mexican Americans, but not in blacks. In blacks, the association of sUA with lumbar BMD was an inverted U-shaped curve (inflection point: 7.5 mg/dL).

CONCLUSIONS

Our study revealed a positive relationship between sUA and lumbar BMD among most old adults. This association followed an inverted U-shaped curve among blacks.

Assessment of Risk Factors for Fractures in Patients with Type 2 Diabetes over 60 Years Old: A Cross-Sectional Study from Northeast China

AIMS

Previous evidence has demonstrated an increased fracture risk among the population with type 2 diabetes mellitus (T2DM). This study investigated the prevalence of bone fractures in elderly subjects (with and without type 2 diabetes) and identified any fracture risk factors, especially the risk factors for common known fractures in particular diabetic populations.

METHODS

This cross-sectional study was conducted with community-dwelling people over 60 years old in nine communities from the city of Shenyang, which is the capital of Northeast China's Liaoning Province. A total of 3430 elderly adults (2201 females, mean ± standard deviation age 68.16 ± 6.1 years; 1229 males, 69.16 ± 6.7 years) were included. Our study measured the heel bone mineral density (BMD) and used the timed "up and go" (TUG) test and other indicators. In addition, we performed logistic regression analysis to explore the risk factors for fractures in the general population and the diabetic population and to analyze the differences.

RESULTS

The results revealed that a total of 201 elderly persons (5.8%), with an average age of 70.05 ± 6.54 years, suffered from a history of fragility fractures, which affected more females (74.6%) than males (p = 0.001). The prevalence of fractures in the T2DM population was 7.3%, which was much higher than the 5.2% in non-T2DM population (p = 0.001). The prevalence of fractures in the T2DM population was 7.3%, which was much higher than the 5.2% in non-T2DM population (p = 0.001). The prevalence of fractures in the T2DM population was 7.3%, which was much higher than the 5.2% in non-T2DM population (p = 0.001). The prevalence of fractures in the T2DM population was 7.3%, which was much higher than the 5.2% in non-T2DM population (T-score≤-2.5 (OR 1.750) were independent risk factors for fragility fractures in the non-T2DM population, but they were not risk factors in the T2DM population.

CONCLUSIONS

This study found that low BMD and slow TUG time were independent risk factors for fractures in non-T2DM patients, while no associations were found in the T2DM population. Patients with T2DM have a higher risk for fractures even when they have sufficient BMD and a short TUG time. TUG and BMD underestimated the risk for fractures in the T2DM population.