{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:05:48Z","timestamp":1784696748748,"version":"3.55.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Mol. Biosci."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Insulin resistance (IR) contributes to osteoporosis (OP) by impairing bone microarchitecture, posing significant fragility-fracture risk in patients with type 2 diabetes mellitus (T2DM). The triglyceride\u2013glucose (TyG) index and its anthropometry-adjusted derivatives (TyG\u2013body mass index [BMI], TyG\u2013waist circumference [WC]) are simple IR surrogates that may aid OP risk stratification. This study evaluated TyG, TyG-BMI and TyG-WC as independent predictors for OP in T2DM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a retrospective cohort of 568 patients with T2DM (36 OP cases), baseline clinical, laboratory (HbA1c, haemoglobin [HGB], high-density lipoprotein cholesterol [HDL], serum calcium [Ca]) and bone-metabolism (procollagen type 1 N-terminal propeptide [P1NP], osteocalcin [OC], bone-specific alkaline phosphatase [BAP]) data were analyzed. Candidate covariates were selected by least absolute shrinkage and selection operator (LASSO) regression with variance inflation factors (VIF) screening. Because the events-per-variable ratio was low (\u22484), three Firth\u2019s penalised-likelihood logistic regression models were fitted for TyG, TyG-BMI or TyG-WC as the primary analysis. Discrimination was assessed by the area under the receiver-operating-characteristic curve (AUC) with 95% confidence intervals (CIs) and pairwise DeLong tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All three indices were significantly higher in OP than non-OP patients (all P &amp;lt; 0.001). After Firth-penalised adjustment, only remained independently associated with TyG-WC (OR 1.004; 95% CI 1.001\u20131.008; P = 0.013); TyG (P = 0.075) and TyG-BMI (P = 0.105) showed positive but non-significant associations. Higher HbA1c, OC and BAP increased the odds of OP, while male sex and higher HGB were protective. Discrimination was high and similar across models (apparent AUCs: 0.896 [TyG], 0.887 [TyG-BMI] and 0.901 [TyG-WC], with no DeLong-significant difference between indices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among the three IR surrogates, only TyG-WC was independently associations with OP in T2DM, although overall discrimination was comparable across indices. TyG-WC may serve as low-cost adjuncts for identifying diabetic patients at elevated OP risk, pending prospective external validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmolb.2026.1795616","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:38:18Z","timestamp":1784695098000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictive value of insulin resistance related indicators for osteoporosis risk in patients with type 2 diabetes mellitus: a real-world study"],"prefix":"10.3389","volume":"13","author":[{"given":"Qikai","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Shanghai Pudong Hospital, Fudan University Pudong Medical Center","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Jian","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Shanghai Pudong Hospital, Fudan University Pudong Medical Center","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"641","DOI":"10.3969\/j.issn.1006-7108.2021.05.004","article-title":"Correlation analysis among the influential factors of diabetic osteoporosis","volume":"27","author":"Chen","year":"2021","journal-title":"Chin. 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