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Author Notes:

Corresponding author: Email: AAshraf@peds.uab.edu

Authors' contributions This work was carried out in collaboration between all authors.

Author APA made substantial contributions to study conception, design, protocol writing and interpretation of data and drafted the article.

Author JA participated in the study conception and design and was involved in the acquisition of data, design and conduct of the protocol and interpretation of data.

Author CH performed the statistical analysis and was involved in the interpretation of data.

Author KC was involved in interpretation of the data, literature search and preparation of manuscript.

Author BG participated in study design and conduct of protocol and revised the article critically for important intellectual content.

All authors approved the final version of the manuscript.

CONSENT: All authors declare that written informed consent and assent was obtained from the parents and patients.

COMPETING INTERESTS: Authors have declared that no competing interests exist.


Research Funding:

This study was funded by UAB Diabetes Research Training Center (P60 DK- 079626) and by Child Health Research Center Grant K12 HD043397 (T0909180013), and was supported by the Center for Clinical and Translational Science (5UL1 RR025777).

JAA was supported by the American Heart Association (Greater Southeast Affiliate).

The NORC core lab (P30DK56336) and DRTC core lab (P60DK079626) for laboratory analyses and body composition analyses are supported by grants from the National Institutes of Health.


  • Bone mineral density
  • insulin secretion
  • ethnic differences
  • bone mass

Higher Serum Insulin Concentrations Positively Influence the Bone Mineral Density in African American Adolescents


Journal Title:

British Journal of Medicine and Medical Research


Volume 3, Number 4


, Pages 1050-1061

Type of Work:

Article | Final Publisher PDF


Background: Puberty is a developmental stage of increased insulin resistance that also is a critical period for bone mass accrual. Historically, African Americans (AA) have lesser risk for osteoporotic fractures compared to European Americans (EA). AA also have higher incidence of insulin resistance. The possibility that bone health and insulin secretion or concentrations are linked has not been investigated. Aims: We aimed to examine the associations of bone mineral density (BMD) and bone mineral apparent density (BMAD) with insulin sensitivity and secretion in healthy adolescent girls and healthy female adults and to evaluate ethnic differences in these associations. Study Design: Observational cohort design. Place and Duration of the Study: University of Alabama at Birmingham, between January 2010 and September 2011. Methodology: Healthy, female, non-smoking adolescents and young adults (14–55 years) were enrolled in this observational cohort study. Results: Adolescents had significantly higher fasting insulin (P=0.0002), insulin area under the curve [AUC] (P= 0.0004) and lower insulin sensitivity (P=0.0005) compared to adults. Among adolescents, AA race was significantly associated with BMD (β=0.086, P=0.01) and BMAD (β=0.0075, P=0.002); however, adjusting for insulin AUC explained this difference. Insulin AUC (β=0.0006, P=0.029) and fasting insulin (β=0.0005, P=0.01) were positively associated with BMAD only in AA adolescents. Insulin AUC and fasting insulin were not significant predictors of BMD for adults. Conclusion: The higher insulin concentration among AA adolescents is associated with increased BMD and higher BMAD.

Copyright information:

© 2013 Ashraf et al

This is an Open Access work distributed under the terms of the Creative Commons Attribution 3.0 Unported License (http://creativecommons.org/licenses/by/3.0/).

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