Bone quantitative ultrasound measurements in relation to the metabolic syndrome and type 2 diabetes mellitus in a cohort of elderly subjects at high risk of cardiovascular disease from the PREDIMED study

J Nutr Health Aging. 2011 Dec;15(10):939-44. doi: 10.1007/s12603-011-0046-0.


Objective: The aim of this study is to determine whether metabolic syndrome, its individual components, or the presence of type 2 diabetes mellitus are associated with a better bone status estimated by quantitative ultrasound at the calcaneus.

Design: Cross-sectional study.

Setting: Outpatient clinics.

Participants: 251 elderly subjects at high cardiovascular risk from the PREDIMED study were included.

Measurements: MetS was defined according to the ATPIII diagnosis criteria. Calcaneus quantitative ultrasound (QUS) assessment was performed using the Sahara system.

Results: Subjects with MetS showed significantly lower 24-hour urinary deoxypyridinoline/creatinine (u-DPD/creatinine) levels and higher broadband ultrasound attenuation, and a tendency to higher bone mineral density (BMD) and quantitative ultrasound index (QUI) than their counterparts. Individuals with type 2 diabetes mellitus (T2DM) showed a significantly higher bone broadband ultrasound attenuation (BUA) and QUI than their non-diabetic counterparts, despite they shown a higher prevalence of osteoporotic fractures. Multiple linear regression analyses showed that quantitative ultrasound parameters were positively associated with the metabolic syndrome and T2DM. Of the bone biochemical markers, only u-DPD/creatinine was related to MetS, abdominal obesity, hypertriglyceridemia component of the MetS, and the number of features that define the MetS.

Conclusion: This is the first study showing a positive association between MetS or T2DM with better bone status and lower bone resorption markers measured by quantitative ultrasound. Our results suggest that metabolic abnormalities have a positive effect on healthy bone in elderly subjects at high risk of cardiovascular disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Amino Acids / urine*
  • Biomarkers / urine
  • Bone Density*
  • Bone Resorption / diagnostic imaging*
  • Bone Resorption / urine
  • Bone and Bones / diagnostic imaging
  • Bone and Bones / metabolism*
  • Calcaneus / diagnostic imaging
  • Calcaneus / metabolism
  • Cardiovascular Diseases* / diagnostic imaging
  • Creatinine / urine
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / diagnostic imaging
  • Diabetes Mellitus, Type 2 / metabolism*
  • Diabetes Mellitus, Type 2 / urine
  • Female
  • Fractures, Bone / epidemiology
  • Geriatric Assessment
  • Humans
  • Linear Models
  • Male
  • Metabolic Syndrome / diagnostic imaging
  • Metabolic Syndrome / metabolism*
  • Metabolic Syndrome / urine
  • Outpatients
  • Prevalence
  • Risk
  • Ultrasonography


  • Amino Acids
  • Biomarkers
  • deoxypyridinoline
  • Creatinine