Effect of Body Mass Index on the Relationship Between Serum 25-Hydroxyvitamin D and Bone Mineral Density in Patients With Type 2 Diabetes Mellitus and Osteoporosis

Xiuping Yin; Xiao Sun; Fang Gao; Xinxin Yang; Ningning Guo; Guangya Wang

doi:doi:10.11648/j.sr.20261406.14

Research Article |

| Peer-Reviewed

Effect of Body Mass Index on the Relationship Between Serum 25-Hydroxyvitamin D and Bone Mineral Density in Patients With Type 2 Diabetes Mellitus and Osteoporosis

Xiuping Yin^*, Xiao Sun, Fang Gao, Xinxin Yang, Ningning Guo, Guangya Wang

Published in Science Research (Volume 14, Issue 6)

Received: 26 August 2026 Accepted: 2 November 2026 Published: 10 November 2026

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Abstract

Objective to explore the relationship between serum 25-hydroxyvitamin D [25 (OH)D] and bone mineral density (BMD) in patients with type 2 diabetes mellitus (T2DM) complicated with osteoporosis at different body mass index (BMI) levels, and to assess the modifying effect of BMI. Methods A total of 338 hospitalized patients with T2DM and osteoporosis from January 2021 to January 2024 were enrolled. According to BMI, patients were divided into normal-weight, overweight, and obese groups. Multiple linear regression analyses were performed with lumbar spine, femoral neck, and total hip T-scores as dependent variables and 25 (OH)D as the independent variable, adjusting for age, sex, and glycated hemoglobin (HbA1c). An interaction term between 25 (OH)D and BMI was included. Sensitivity analysis was conducted using the lowest T-score. Results In the normal-weight and overweight groups, 25 (OH)D was positively correlated with lumbar spine, femoral neck, and total hip T-scores, with the strongest correlation observed at the total hip. No significant correlation was found in the obese group. Interaction analysis indicated that BMI modified the association between 25 (OH)D and total hip T-score. The results of sensitivity analysis were consistent. Conclusion Serum 25 (OH)D is positively correlated with BMD in patients with T2DM complicated with osteoporosis. This association may be modified by BMI, being more evident in normal-weight and overweight patients but not statistically significant in obese patients.

Published in	Science Research (Volume 14, Issue 6)
DOI	10.11648/j.sr.20261406.14
Page(s)	419-425
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2026. Published by Science Publishing Group

Keywords

Type 2 Diabetes Mellitus, Osteoporosis, 25-hydroxyvitamin D, Bone Mineral Density, Body Mass Index

1．资料与方法

与一般骨质疏松人群相比，2型糖尿病（T2DM）相关骨损害具有更为复杂的病理生理基础，既涉及胰岛素抵抗、慢性低度炎症及晚期糖基化终末产物（AGEs）蓄积

[1-3]

，也与骨转换异常及维生素D代谢紊乱密切相关

[4]

。既往研究提示，维生素D不足与骨密度下降、骨折风险升高及代谢异常有关

[4, 5]

。近年来，多项研究表明，维生素D不仅参与骨代谢调节，还可能与2型糖尿病（T2DM）的发生风险密切相关

[6]

。有研究指出血浆25-羟维生素D[25(OH)D]水平与T2DM的发病风险呈负相关，补充维生素D则可有效降低T2DM的发病风险，改善患者血糖控制和胰岛素抵抗程度

[7, 8]

。然而，在T2DM合并骨质疏松这一高风险人群中，25(OH)D与不同部位骨密度之间的关系仍需进一步细化研究。

体重指数（BMI）是影响骨代谢的重要因素。一方面，较高体重带来的机械负荷可能对骨量具有一定保护作用；另一方面，肥胖状态下脂肪组织对维生素D的储存、生物利用度下降及炎症反应增强，又可能削弱维生素D对骨代谢的有益影响

[9-11]

。在T2DM人群中，维生素D、肥胖与骨代谢之间存在复杂的相互作用

[12, 13]

。基于此，本研究拟在T2DM合并骨质疏松患者中，按BMI分层分析25(OH)D与腰椎、股骨颈及全髋骨密度T值的关系，并进一步通过交互作用模型和敏感性分析验证结果稳健性，以期为不同体重状态的2型糖尿病患者骨健康管理提供依据。

1.1．研究对象

回顾性搜集2021年1月至2024年1月在我院内分泌科住院的T2DM合并骨质疏松患者。所有入院患者均符合以下纳入标准：①T2DM诊断参照1999年WHO糖尿病诊断标准

[14]

，即有典型糖尿病症状（多饮、多尿、多食、体重下降），随机血糖≥11.1mmol/L，或空腹血糖≥7.0mmol/L，或口服葡萄糖耐量试验2小时血糖≥11.1mmol/L；②骨质疏松的诊断参照《原发性骨质疏松症诊疗指南（2022版）》相关标准

[15]

。通过双能X线骨密度仪测定骨密度，T值≤-2.5SD。同时符合以上纳入标准的患者纳入本研究。排除标准：①1型糖尿病、妊娠期糖尿病或其他特殊类型糖尿病；②全身状况较差，无法配合完成相关检查和评估；③有恶性肿瘤病史；④有严重肝肾功能不全者或其他影响维生素D水平的代谢性疾病；⑤近3个月内使用过影响骨代谢或维生素D代谢的药物。对原始数据进行质量核查后，纳入BMI处于合理生理区间（18.5~60 kg/m²）的患者338例，本研究已获得伦理委员会批准。

1.2．临床资料采集

详细收集患者的临床资料，包括年龄、性别、BMI、糖化血红蛋白（HbA1c）、空腹胰岛素、空腹C肽及25(OH)D水平，并计算胰岛素抵抗指数（HOMA-IR）值和胰岛 β 细胞功能（HOMA-β）值；应用美国Hologic双能X线骨密度仪对所有患者的腰椎（L1-L4）和双侧股骨颈、全髋进行骨密度测定。骨密度结果以T值表示，表示所测骨密度与同性别健康年轻人群的骨密度水平比较的标准差数。以三部位T值中的最低值定义为最低T值，用于敏感性分析。本研究经沧州市中心医院伦理委员会批准（伦理审批号：2024-280-02）。

1.3．BMI分层

依据《肥胖症诊疗指南（2024年版）》的标准，将BMI＜24 kg/m²定义为正常组，24～＜28 kg/m²定义为超重组，BMI≥28 kg/m²定义为肥胖组

[16]

。

1.4．统计分析

采用SPSS 26.0及R软件进行统计分析。符合正态分布的计量资料以 x±s 表示，多组间比较采用单因素方差分析；偏态分布资料采用Kruskal-Wallis H检验；计数资料采用χ²检验。采用Spearman相关分析评价25(OH)D与骨密度及糖代谢指标的相关性。以各部位骨密度T值为因变量，25(OH)D为自变量，构建多元线性回归模型，按BMI分层（正常、超重、肥胖）分析，并调整年龄、性别及HbA1c等混杂因素，计算β值及95%CI。通过纳入BMI与25(OH)D交互项评估交互作用，并进行敏感性分析以检验结果稳健性。所有检验均为双侧，P＜0.05为差异有统计学意义。

2．结果

2.1．不同BMI组基线特征

共纳入338例患者，其中正常组138例、超重组165例、肥胖组35例。三组年龄和HbA1c水平比较，差异无统计学意义（P > 0.05）；女性比例在三组间差异有统计学意义（P < 0.05）。三组间BMI、25(OH)D、腰椎T值、股骨颈T值、全髋T值、空腹胰岛素、空腹C肽、HOMA-IR及HOMA-β 比较，差异均有统计学意义（P < 0.001）。具体见表1。

表1 不同BMI组患者基线特征。

指标	正常组（n=138）	超重组 (n=165)	肥胖组 (n=35)	H/χ²值	P值
年龄（岁）	59.18±5.70	59.17±5.23	59.03±5.07	0.507	0.776
女性[n(%)]	72 (52.2)	81 (49.1)	25 (71.4)	7.415	0.025
BMI (kg/m²)	22.22±1.68	25.04±0.77	32.02±2.67	274.488	<0.001
25(OH)D（ng/mL）	19.13±9.12	26.12±9.39	37.73±3.19	88.107	<0.001
HbA1c	8.17±1.71	8.21±1.72	7.86±1.84	1.489	0.475
腰椎T值	-3.13±0.59	-2.92±0.56	-2.65±0.49	19.377	<0.001
股骨颈T值	-3.26±0.73	-3.00±0.56	-2.75±0.38	22.749	<0.001
全髋T值	-2.96±0.70	-2.89±0.66	-2.46±0.50	16.019	<0.001
空腹胰岛素	4.40±1.25	5.22±1.48	6.86±1.26	71.325	<0.001
空腹C肽	1.66±0.31	1.82±0.31	2.24±0.24	79.310	<0.001
HOMA-IR	3.92±0.80	3.58±0.82	2.82±0.35	55.695	<0.001
HOMA-β	46.79±10.01	53.72±11.08	66.02±7.14	80.337	<0.001

注：计量资料以 x±s 表示。25-羟维生素D为25(OH)D；体重指数为BMI；糖化血红蛋白为HbA1c；胰岛素抵抗指数为HOMA-IR；胰岛β 细胞功能为HOMA-β。

2.2．各指标相关性分析

在描述性分析基础上，进一步采用Spearman相关分析探讨25(OH)D水平与骨密度及糖代谢相关指标之间的关系。结果显示，25(OH)D水平与腰椎T值、股骨颈T值及全髋T值均呈正相关，有统计学意义。

在糖代谢指标方面，25(OH)D水平与空腹胰岛素、空腹C肽及HOMA-β呈正相关，而与HOMA-IR呈负相关。但25(OH)D与HbA1c之间未见相关性（P > 0.05）。此外，各骨密度指标之间亦呈正相关，而HOMA-IR与骨密度指标呈负相关。

Download: Download full-size image

Figure 1. 图1 25(OH)D水平与骨密度及糖代谢指标的Spearman相关性热图（下三角显示）。

注：颜色深浅表示相关性强弱；正值为正相关，负值为负相关

25(OH)D为25-羟维生素D；HbA1c为糖化血红蛋白；HOMA-β为胰岛β细胞功能指数；HOMA-IR为胰岛素抵抗指数。*P<0.05，**P<0.01。

2.3．不同BMI层内25(OH)D与各部位T值的多元线性回归分析

在上述相关性分析基础上，进一步采用多元线性回归模型，在调整性别、年龄及HbA1c等混杂因素后，对不同BMI分层内25(OH)D与各部位骨密度T值进行多元线性回归分析。结果显示，在正常组和超重组中，25(OH)D与腰椎、股骨颈及全髋T值均呈正相关（均P < 0.01）；而在肥胖组中，25(OH)D与上述各部位T值的关联均未达到统计学意义（均P > 0.05）。见表2。

表2 不同BMI层内25(OH)D与各部位T值的多元线性回归分析。

BMI分层	部位	样本量	β	95%置信区间	P值
正常组	腰椎	138	0.028	0.018~0.038	<0.01
正常组	股骨颈	138	0.031	0.019~0.044	<0.01
正常组	全髋	138	0.035	0.023~0.046	<0.01
超重组	腰椎	165	0.021	0.012~0.030	<0.01
超重组	股骨颈	165	0.028	0.020~0.036	<0.01
超重组	全髋	165	0.040	0.031~0.049	<0.01
肥胖组	腰椎	35	-0.014	-0.067~0.039	0.60
肥胖组	股骨颈	35	-0.003	-0.045~0.040	0.90
肥胖组	全髋	35	0.041	-0.015~0.096	0.15

注：模型调整年龄、性别及HbA1c。BMI为体重指数；25(OH)D为25-羟维生素D；HbA1c为糖化血红蛋白；CI为置信区间。

2.4．不同BMI层内25(OH)D与各部位T值关联的森林图

为更直观展示不同BMI分层中25(OH)D对骨密度的影响效应，进一步绘制森林图进行结果可视化。如图2所示，25(OH)D水平在正常组及超重组中均与腰椎、股骨颈及全髋T值呈正相关（均P < 0.01）。而在肥胖组中，25(OH)D与各部位T值之间未观察到统计学意义（均P > 0.05）。

Download: Download full-size image

Figure 2. 图2 不同BMI层内25(OH)D与各部位T值关联的森林图。

注：点表示回归系数（β值），横线表示95%置信区间（95% CI），虚线表示β=0。纵轴为不同BMI分层及骨密度测量部位（腰椎、股骨颈、全髋）。β值＞0表示25(OH)D水平与骨密度T值呈正相关，β值＜0表示负相关。

2.5．BMI与25(OH)D交互作用分析

基于分层分析结果，进一步纳入BMI与25(OH)D的交互项进行分析，探讨BMI在两者关系中的调节作用。结果显示，在调整性别、年龄及HbA1c等混杂因素后，在全髋骨密度中，BMI与25(OH)D之间存在交互作用（P = 0.019），而在腰椎及股骨颈部位未观察到统计学交互效应（P > 0.05）。见表3。

表3 BMI与25(OH)D交互作用分析。

部位	交互项β	95%置信区间	P值
腰椎	-0.000	-0.002~0.001	0.76
股骨颈	-0.001	-0.003~0.001	0.23
全髋	0.002	0.000~0.004	0.02

注：交互项β表示BMI与25(OH)D的交互效应系数；模型调整年龄、性别及HbA1c。

2.6．敏感性分析

为验证研究结果的稳健性，在调整性别、年龄、BMI及HbA1c等混杂因素后，以最低T值作为结局变量进行敏感性分析。结果显示，25(OH)D水平与最低T值仍呈正相关（β = 0.031，95%CI：0.024～0.037，P <0.01），见表4。

表4 以最低T值为结局的敏感性分析。

变量	β	95%置信区间	P值
25(OH)D	0.031	0.024~0.037	<0.01

注：模型调整年龄、性别、BMI及HbA1c。最低T值为腰椎、股骨颈及全髋T值中的最低值。

3．讨论

随着人口老龄化进程加快及2型糖尿病（type 2 diabetes mellitus，T2DM）患病率持续上升，T2DM已成为全球重要的慢性病负担之一

[17, 18]

。流行病学研究显示，T2DM患者骨质疏松患病率较高，可达30%–40%，且随年龄增长呈上升趋势

[2, 19]

。在老龄化背景下，骨质疏松及骨折风险进一步增加，已成为重要的公共卫生问题

[20]

。与原发性骨质疏松不同，T2DM患者的骨代谢异常并非仅由年龄增长或绝经等传统因素所致，还与长期高血糖、胰岛素抵抗、慢性低度炎症及晚期糖基化终末产物（advanced glycation end products，AGEs）沉积等糖尿病相关机制密切相关

[1, 21]

。既往研究表明，T2DM患者即使骨密度正常甚至升高，其骨折风险仍显著增加，提示该人群骨脆性的发生并不能完全由骨密度解释，骨质量受损可能更为关键

[22, 23]

。因此，从糖骨代谢整体角度探讨影响骨健康的相关因素，对于该类患者的风险识别和临床管理具有重要意义。

既往研究已证实，25(OH)D在骨代谢和糖代谢中均发挥重要作用

[24, 25]

。在骨代谢方面，25(OH)D可通过调节钙磷代谢、促进成骨细胞分化及抑制骨吸收来维持骨稳态；在糖代谢方面，维生素D还可能通过改善胰岛素分泌及敏感性、减轻炎症反应等途径参与葡萄糖代谢调控

[24-26]

。本研究在T2DM合并骨质疏松患者中发现，25(OH)D水平与腰椎、股骨颈及全髋骨密度T值呈正相关，提示维生素D可能是该人群骨健康的重要影响因素。

BMI作为反映体重状态的重要指标，在骨代谢中具有较为复杂的双重作用

[27]

。一方面，较高体重所带来的机械负荷可刺激骨形成，从而在一定程度上提高骨密度；另一方面，肥胖状态常伴随慢性低度炎症、脂肪因子分泌异常及代谢紊乱，这些因素又可能抑制成骨、促进骨吸收，从而对骨代谢产生不利影响

[27, 28]

。本研究进一步进行BMI分层多元回归分析后发现，正常组和超重组中，25(OH)D与腰椎、股骨颈及全髋T值均存在较为稳定的独立正相关，而在肥胖组中上述相关性未达到统计学意义，提示BMI升高可能削弱二者关系，表明BMI不仅是骨密度的重要影响因素，也影响维生素D在骨代谢中的生物学作用。

本研究的交互作用模型结果在一定程度上支持了BMI并非单纯混杂因素，而可能参与调节维生素D与骨密度之间关系的观点。其潜在机制可能包括：肥胖状态下脂肪组织对维生素D的储存作用增加，导致其生物利用度下降；与此同时，维生素D不足又可能加重胰岛素抵抗，而胰岛素抵抗及高血糖状态进一步通过AGEs蓄积、氧化应激等途径损伤骨组织

[10, 21]

。这一发现也与近年研究报道的趋势一致，即肥胖状态下维生素D对代谢及骨骼系统的影响可能具有一定异质性

[25]

。因此，在评估维生素D与骨密度关系时，应充分考虑体重状态的影响。

从不同骨骼部位来看，本研究中25(OH)D与全髋T值的关联最为稳定，BMI与25(OH)D之间的交互作用也主要体现在全髋部位。这提示体重状态对髋部骨代谢的影响可能更为敏感。一方面，髋部属于典型负重骨，更易受到体重及机械负荷变化的影响；另一方面，肥胖相关代谢异常和慢性低度炎症可能通过影响骨转换过程，改变维生素D在髋部骨代谢中的作用强度

[27]

。值得注意的是，肥胖组中未观察到统计学意义，并不代表维生素D在该人群中不具有生物学意义，其作用可能受到脂肪组织储存、生物利用度下降、炎症反应增强及其他代谢异常等多种因素的共同影响

[10, 27]

。此外，肥胖组样本量较小，也可能降低了统计效能。因此，在肥胖的2型糖尿病患者中，仅依据外周血25(OH)D水平判断骨健康风险可能存在一定局限，应结合体重状态、骨密度部位特征及其他骨代谢相关指标进行综合评估。

本研究敏感性分析采用最低T值作为结局指标后，结果总体仍保持一致，提示本研究主结果具有较好的稳健性。本研究亦存在一定局限性。首先，本研究为单中心回顾性研究，样本代表性有限，且尚不能据此推断明确的因果关系；其次，本研究未纳入降糖治疗方案、体力活动、饮食摄入及骨转换标志物等潜在混杂因素，可能对结果产生一定影响；此外，部分BMI分层后的样本量相对较小，尤其是肥胖组，可能降低统计效能。未来仍需开展大样本、多中心及前瞻性研究，并结合更多代谢及骨转换相关指标，进一步验证本研究结论并阐明其潜在机制。

总体而言，本研究结果提示，在T2DM患者骨健康管理中，应从糖代谢、体重状态、维生素D营养状况及骨密度等多个维度进行综合评估，而非仅依赖单一指标。尤其对于不同BMI状态的患者，维生素D与骨密度之间的关系可能存在差异，这提示临床干预策略应更加重视分层评估和个体化管理。

4．结论

在2型糖尿病合并骨质疏松患者中，25(OH)D与腰椎、股骨颈及全髋骨密度T值总体呈正相关。BMI对该关系具有修饰作用：在正常体重和超重患者中，25(OH)D与骨密度关联明确；在肥胖患者中未观察到明显关联。临床上应结合BMI状态，对维生素D水平及骨健康风险进行个体化评估。

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Yin, X., Sun, X., Gao, F., Yang, X., Guo, N., et al. (2026). Effect of Body Mass Index on the Relationship Between Serum 25-Hydroxyvitamin D and Bone Mineral Density in Patients With Type 2 Diabetes Mellitus and Osteoporosis. Science Research, 14(6), 419-425. https://doi.org/10.11648/j.sr.20261406.14

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Yin, X.; Sun, X.; Gao, F.; Yang, X.; Guo, N., et al. Effect of Body Mass Index on the Relationship Between Serum 25-Hydroxyvitamin D and Bone Mineral Density in Patients With Type 2 Diabetes Mellitus and Osteoporosis. Sci. Res. 2026, 14(6), 419-425. doi: 10.11648/j.sr.20261406.14

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Yin X, Sun X, Gao F, Yang X, Guo N, et al. Effect of Body Mass Index on the Relationship Between Serum 25-Hydroxyvitamin D and Bone Mineral Density in Patients With Type 2 Diabetes Mellitus and Osteoporosis. Sci Res. 2026;14(6):419-425. doi: 10.11648/j.sr.20261406.14

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@article{10.11648/j.sr.20261406.14,
  author = {Xiuping Yin and Xiao Sun and Fang Gao and Xinxin Yang and Ningning Guo and Guangya Wang},
  title = {Effect of Body Mass Index on the Relationship Between Serum 25-Hydroxyvitamin D and Bone Mineral Density in Patients With Type 2 Diabetes Mellitus and Osteoporosis},
  journal = {Science Research},
  volume = {14},
  number = {6},
  pages = {419-425},
  doi = {10.11648/j.sr.20261406.14},
  url = {https://doi.org/10.11648/j.sr.20261406.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sr.20261406.14},
  abstract = {Objective to explore the relationship between serum 25-hydroxyvitamin D [25 (OH)D] and bone mineral density (BMD) in patients with type 2 diabetes mellitus (T2DM) complicated with osteoporosis at different body mass index (BMI) levels, and to assess the modifying effect of BMI. Methods A total of 338 hospitalized patients with T2DM and osteoporosis from January 2021 to January 2024 were enrolled. According to BMI, patients were divided into normal-weight, overweight, and obese groups. Multiple linear regression analyses were performed with lumbar spine, femoral neck, and total hip T-scores as dependent variables and 25 (OH)D as the independent variable, adjusting for age, sex, and glycated hemoglobin (HbA1c). An interaction term between 25 (OH)D and BMI was included. Sensitivity analysis was conducted using the lowest T-score. Results In the normal-weight and overweight groups, 25 (OH)D was positively correlated with lumbar spine, femoral neck, and total hip T-scores, with the strongest correlation observed at the total hip. No significant correlation was found in the obese group. Interaction analysis indicated that BMI modified the association between 25 (OH)D and total hip T-score. The results of sensitivity analysis were consistent. Conclusion Serum 25 (OH)D is positively correlated with BMD in patients with T2DM complicated with osteoporosis. This association may be modified by BMI, being more evident in normal-weight and overweight patients but not statistically significant in obese patients.},
 year = {2026}
}

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TY - JOUR
T1 - Effect of Body Mass Index on the Relationship Between Serum 25-Hydroxyvitamin D and Bone Mineral Density in Patients With Type 2 Diabetes Mellitus and Osteoporosis
AU - Xiuping Yin
AU - Xiao Sun
AU - Fang Gao
AU - Xinxin Yang
AU - Ningning Guo
AU - Guangya Wang
Y1 - 2026/11/10
PY - 2026
N1 - https://doi.org/10.11648/j.sr.20261406.14
DO - 10.11648/j.sr.20261406.14
T2 - Science Research
JF - Science Research
JO - Science Research
SP - 419
EP - 425
PB - Science Publishing Group
SN - 2329-0927
UR - https://doi.org/10.11648/j.sr.20261406.14
AB - Objective to explore the relationship between serum 25-hydroxyvitamin D [25 (OH)D] and bone mineral density (BMD) in patients with type 2 diabetes mellitus (T2DM) complicated with osteoporosis at different body mass index (BMI) levels, and to assess the modifying effect of BMI. Methods A total of 338 hospitalized patients with T2DM and osteoporosis from January 2021 to January 2024 were enrolled. According to BMI, patients were divided into normal-weight, overweight, and obese groups. Multiple linear regression analyses were performed with lumbar spine, femoral neck, and total hip T-scores as dependent variables and 25 (OH)D as the independent variable, adjusting for age, sex, and glycated hemoglobin (HbA1c). An interaction term between 25 (OH)D and BMI was included. Sensitivity analysis was conducted using the lowest T-score. Results In the normal-weight and overweight groups, 25 (OH)D was positively correlated with lumbar spine, femoral neck, and total hip T-scores, with the strongest correlation observed at the total hip. No significant correlation was found in the obese group. Interaction analysis indicated that BMI modified the association between 25 (OH)D and total hip T-score. The results of sensitivity analysis were consistent. Conclusion Serum 25 (OH)D is positively correlated with BMD in patients with T2DM complicated with osteoporosis. This association may be modified by BMI, being more evident in normal-weight and overweight patients but not statistically significant in obese patients.
VL - 14
IS - 6
ER -

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Xiuping Yin

Department of Endocrinology and Diabetes II, Cangzhou Central Hospital, Cangzhou, China

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Xiao Sun

Department of Tuberculosis I, Cangzhou Third Hospital, Cangzhou, China
Fang Gao

Department of Endocrinology and Diabetes II, Cangzhou Central Hospital, Cangzhou, China
Xinxin Yang

Department of Endocrinology and Diabetes II, Cangzhou Central Hospital, Cangzhou, China
Ningning Guo

Department of Endocrinology and Diabetes II, Cangzhou Central Hospital, Cangzhou, China
Guangya Wang

Department of Endocrinology and Diabetes II, Cangzhou Central Hospital, Cangzhou, China

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Figure 1

Figure 1. 图 1 25(OH)D水平与骨密度及糖代谢指标的Spearman相关性热图（下三角显示）。
Figure 2

Figure 2. 图 2 不同BMI层内25(OH)D与各部位T值关联的森林图。

Table 1

表1 不同BMI组患者基线特征。
Table 2

表2 不同BMI层内25(OH)D与各部位T值的多元线性回归分析。
Table 3

表3 BMI与25(OH)D交互作用分析。
Table 4

表4 以最低T值为结局的敏感性分析。

Plain Text BibTeX RIS

APA Style

Yin, X., Sun, X., Gao, F., Yang, X., Guo, N., et al. (2026). Effect of Body Mass Index on the Relationship Between Serum 25-Hydroxyvitamin D and Bone Mineral Density in Patients With Type 2 Diabetes Mellitus and Osteoporosis. Science Research, 14(6), 419-425. https://doi.org/10.11648/j.sr.20261406.14

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ACS Style

Yin, X.; Sun, X.; Gao, F.; Yang, X.; Guo, N., et al. Effect of Body Mass Index on the Relationship Between Serum 25-Hydroxyvitamin D and Bone Mineral Density in Patients With Type 2 Diabetes Mellitus and Osteoporosis. Sci. Res. 2026, 14(6), 419-425. doi: 10.11648/j.sr.20261406.14

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AMA Style

Yin X, Sun X, Gao F, Yang X, Guo N, et al. Effect of Body Mass Index on the Relationship Between Serum 25-Hydroxyvitamin D and Bone Mineral Density in Patients With Type 2 Diabetes Mellitus and Osteoporosis. Sci Res. 2026;14(6):419-425. doi: 10.11648/j.sr.20261406.14

Copy | Download

@article{10.11648/j.sr.20261406.14,
  author = {Xiuping Yin and Xiao Sun and Fang Gao and Xinxin Yang and Ningning Guo and Guangya Wang},
  title = {Effect of Body Mass Index on the Relationship Between Serum 25-Hydroxyvitamin D and Bone Mineral Density in Patients With Type 2 Diabetes Mellitus and Osteoporosis},
  journal = {Science Research},
  volume = {14},
  number = {6},
  pages = {419-425},
  doi = {10.11648/j.sr.20261406.14},
  url = {https://doi.org/10.11648/j.sr.20261406.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sr.20261406.14},
  abstract = {Objective to explore the relationship between serum 25-hydroxyvitamin D [25 (OH)D] and bone mineral density (BMD) in patients with type 2 diabetes mellitus (T2DM) complicated with osteoporosis at different body mass index (BMI) levels, and to assess the modifying effect of BMI. Methods A total of 338 hospitalized patients with T2DM and osteoporosis from January 2021 to January 2024 were enrolled. According to BMI, patients were divided into normal-weight, overweight, and obese groups. Multiple linear regression analyses were performed with lumbar spine, femoral neck, and total hip T-scores as dependent variables and 25 (OH)D as the independent variable, adjusting for age, sex, and glycated hemoglobin (HbA1c). An interaction term between 25 (OH)D and BMI was included. Sensitivity analysis was conducted using the lowest T-score. Results In the normal-weight and overweight groups, 25 (OH)D was positively correlated with lumbar spine, femoral neck, and total hip T-scores, with the strongest correlation observed at the total hip. No significant correlation was found in the obese group. Interaction analysis indicated that BMI modified the association between 25 (OH)D and total hip T-score. The results of sensitivity analysis were consistent. Conclusion Serum 25 (OH)D is positively correlated with BMD in patients with T2DM complicated with osteoporosis. This association may be modified by BMI, being more evident in normal-weight and overweight patients but not statistically significant in obese patients.},
 year = {2026}
}

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