Bone Mass and Density in Youth With Type 2 Diabetes, Obesity, and Healthy Weight

OBJECTIVE Youth-onset type 2 diabetes is an aggressive condition with increasing incidence. Adults with type 2 diabetes have increased fracture risk despite normal areal bone mineral density (aBMD), but the influence of diabetes on the growing skeleton is unknown. We compared bone health in youth with type 2 diabetes to control patients with obesity or healthy weight. RESEARCH DESIGN AND METHODS Cross-sectional study of youth (56% African American, 67% female) ages 10–23 years with type 2 diabetes (n = 180), obesity (BMI >95th; n = 226), or healthy weight (BMI RESULTS We observed age-dependent differences in aBMD and LBMI z scores between the healthy weight, obese, and type 2 diabetes groups. In children, aBMD and LBMI z scores were greater in the type 2 diabetes group versus the obese group, but in adolescents and young adults, aBMD and LBMI z scores were lower in the type 2 diabetes group versus the obese group (age interactions P CONCLUSIONS These results suggest that type 2 diabetes may be detrimental to bone density around the age of peak bone mass. Given the increased fracture risk in adults with type 2 diabetes, there is a pressing need for longitudinal studies aimed at understanding the influence of diabetes on the growing skeleton.