Does obesity mediate the relationship between diabetes and osteoporosis in Chinese elderly population?

Objectives Diabetes mellitus (DM), osteoporosis (OP), and obesity (OB) are three complex diseases. OB is associated with both DM and OP, but it is unclear whether OB mediates association between DM and OP. The study aimed to investigate the potential mediation effects of OB on association between DM and bone mineral density (BMD) by the causal inference tests (CIT). Methods A total of 5682 Chinese aged over 65 years were enrolled in an ongoing cohort: Osteoporosis Preventive Project (OPP). Obesity‐related indexes, including body mass index (BMI), waist circumference, and waist circumference‐hip circumference‐ratio (WHR), and BMD at total hip (TH) and femur neck (FN) were measured. Results Subjects with DM had significant greater values of age, weight, BMI, waist circumference, WHR, and BMD than non‐DM subjects. BMD at TH and FN was significantly associated with DM (p