Type 2 diabetes mellitus (T2D) confers a greater risk of skeletal fragility and fracture. Whether prediabetes is detrimental to bone health is uncertain. We summarize the current data on the associations of prediabetes with bone turnover, bone mineral density, bone quality, bone material properties and fracture risk. In cross-sectional studies, prediabetes was associated with lower bone turnover and worse trabecular bone quality. A longitudinal analysis showed that larger increase in insulin resistance (in the absence of T2D) correlated with faster bone loss. Future research to examine the longitudinal associations of prediabetes with bone health parameters is warranted.
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