{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T19:41:36Z","timestamp":1783021296722,"version":"3.54.6"},"reference-count":58,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Autoimmune diabetes (AD) increases fracture risk. Overweight worsens bone health despite increasing bone mineral density (BMD). This study examines how adiposity influences BMD and Dual X\u2010Ray Absorptiometry (DXA)\u2010derived parameters of bone geometry and strength in AD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>DXA scan was used to assess body mass composition, BMD, trabecular bone score (TBS), and hip structural analysis (HSA)\u2010derived parameters at narrow neck (NN), intertrochanteric (IT) and femur shaft (FS) in 52 normal weight adults with AD and 51 with AD and overweight. Multilinear regression models were used to adjust the associations for age, sex, BMI, HbA1c%, lean mass % and physical activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Total Fat% was negatively associated with markers of bone strength and geometry at different femur sites, including cross\u2010sectional moment of inertia (CSMI) and section modulus (Z) at IT site, cross\u2010sectional area (CSA), CSMI and Z at the FS site and CSMI, buckling ratio (BR) and Z at the NN site, after adjustment for confounders. Visceral adipose tissue emerged as a negative independent predictor of BR at IT and NN. Lean mass % was positively associated with TBS, CSA, CSMI and Z at the IT and FS sites. Negative predictors of bone health were female sex and age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In adults with AD, excess fat mass, including visceral adiposity, is independently associated with impaired hip bone strength and geometry at the femur shaft. These findings highlight the limitations of BMD alone in evaluating bone health in people with AD and overweight, emphasising the negative skeletal effects of adiposity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dmrr.70149","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T07:34:59Z","timestamp":1773905699000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fat Mass Influences Femur Bone Strength and Geometry Parameters, but Not Bone Mineral Density, in Autoimmune Diabetes: A Pilot Study"],"prefix":"10.1002","volume":"42","author":[{"given":"Renata","family":"Risi","sequence":"first","affiliation":[{"name":"Department of Experimental Medicine Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Amendolara","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine 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