Kindler J, Zhan D, Sattler ELP, et al. - Type 2 diabetes-related hazards to peak bone mass may emerge before disease onset, possibly affecting a large proportion of US youth.

• Data from the National Health and Nutrition Examination Survey (2005–2006) were analyzed cross-sectionally in youth aged 12–20 years (49% female, 34% black) with prediabetes (n = 267) and normal glucose regulation (n = 1,664).

• Unadjusted between-group comparisons revealed that youth with prediabetes had higher mean weight and lean body mass index (LBMI) Z-scores than those with normal glucose regulation, but the two groups had identical bone Z-scores.

• While accounting for differences in BMI Z-score, there was a significant interaction between prediabetes status and age with regard to whole body areal bone mineral density (aBMD) Z-score, with children with prediabetes having higher aBMD while adolescents and young adults with prediabetes having lower aBMD.

• Moreover, the positive relationship between LBMI and whole body aBMD was moderated in youth with prediabetes, who had somewhat lower whole body aBMD for a given LBMI.

• The two groups did not differ in terms of lumbar spine bone measurements.