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Background and Purpose: Type 2 diabetes mellitus patients have an increased fracture risk despite having higher areal bone mineral density (aBMD) measured by DXA. This apparent paradox might be explained by the overestimation of BMD by DXA due to the higher fat mass in type 2 diabetes mellitus patients. Volumetric BMD (vBMD) as assessed by quantitative CT (QCT) is not influenced by fat mass. We assessed the association of vBMD and fasting plasma glucose in a large cohort of Chinese subjects and compared the vBMD in healthy and diabetic subjects. In addition, we compared the relation between aBMD, vBMD, glucose and fat mass in a subset of this cohort., Materials and Methods: 10309 participants from the China Biobank project underwent QCT based on chest low dose CT to compute vBMD of L1 and L2 vertebrae and FPG measurements between 2018 and 2019. Among them, 1037 subjects also had spine DXA scans. Data was analyzed using linear regression models., Results: In the total cohort (5889 men and 4420 women, mean age 53 years, range 30-96), there was no significant association between vBMD and FPG after adjustment for age (women: p=0.774; men: p=0.149). 291 women and 606 men fitted the diagnostic criteria of diabetes. Both women and men with diabetes had lower vBMD compared to non-diabetic subjects, but this became non-significant after adjusting for age in the total cohort (women: p=0.817; men: p=0.288) and after propensity score matching based on age (women: p=0.678; men: p=0.135). In the DXA subcohort, aBMD was significantly higher in men with diabetes after adjusting for age and this difference disappeared after further adjusting for total fat area (p=0.064)., Conclusion: We did not find any effect of fasting plasma glucose or diabetes on the volumetric BMD measured with QCT after adjustment for age. Therefore, vBMD measured with QCT might be a more reliable measurement to diagnose osteoporosis and assess fracture risk than aBMD measured with DXA in diabetic patients., Competing Interests: KE is a part-time employee of BioClinica, Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wang, Zhao, Zha, Ran, Su, Yang, Shuang, Liu, Xu, Blake, Cheng, Engelke and Vlug.)

Background The associations of muscle and adipose tissue with bone mineral density (BMD) in perimenopausal women has been studied, but there are differences in site distribution, which lead to that the effect of muscle and adipose tissue on BMD and the site of action are still unclear. Objective To analyze the relationships of BMD in lumbar spine, femoral neck, total hip and adipose, muscle tissue in perimenopausal women, and provide theoretical basis for improving the quality of life of middle-aged and elderly and preventing and treatment of osteoporosis (OP) . Methods 2 355 women aged 40-60 years who underwent medical examination in the Health Management Center, Affiliated Hospital of Guizhou Medical University from January 2018 to October 2021 were retrospectively selected and divided into pre-menopausal women (n=1 261) and post-menopausal women (n=1 094) according to whether they were menopausal or not. BMD of lumbar spine, femoral neck, and total hip were measured by Dual energy X-ray Absorptiometry (DXA) . Adipose and muscle tissue were measured by Bioelectrical Impedance Analysis (BIA) . To explore the association of adipose and muscle tissue with BMD of different site in perimenopausal women by Pearson correlation and multiple linear regression analysis. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of appendicular lean mass (ALM) for postmenopausal OP. Results Pearson correlation analysis showed that adipose mass, total body muscle mass, trunk muscle mass and ALM were positively correlated with BMD of lumbar spine, femoral neck and total hip in premenopausal, postmenopausal and overall women (P