Overweight and underweight are risk factors for vertebral fractures in patients with type 2 diabetes mellitus

The aim of this cross-sectional study was to examine the association between body mass index (BMI) and the prevalence of vertebral fracture (VF) in Japanese patients with type 2 diabetes (T2DM). A total of 798 patients with T2DM were enrolled. VF was determined semi-quantitatively using lateral X-ray films. The association between BMI quartiles (Q1: ≤ 21.2 kg/m 2 , Q2: 21.3–23.4 kg/m 2 , Q3: 23.5–25.8 kg/m 2 , Q4: 25.9≤ kg/m 2 ) and the presence of VF was examined. Multiple logistic regression analyses adjusted for age, sex, diabetes duration, hemoglobin A1c (HbA1c), estimated glomerular filtration rate, and albumin showed that Q1, Q3, and Q4 were significantly associated with an increased VF risk compared to Q2, which served as a reference [Q1; odds ratio (OR) = 1.91, 95% confidence interval (CI) 1.24–2.95, p = 0.004, Q3; OR = 1.65, 95% CI 1.07–2.55, p = 0.023, and Q4; OR = 2.18, 95% CI 1.39–3.41, p