{
  "abstract": "Introduction\n\nDiabetic peripheral neuropathy (DPN) and low appendicular muscle mass (LAMM) may jointly contribute to adverse skeletal outcomes, but their combined effects remain unclear. We examined their associations with osteoporosis, falls, and fractures in patients with Type 2 diabetes.Methods\n\nWe explored associations of diabetes and grip strength with skeletal outcomes using SHARE v8.0.0 (327 248 participants). The primary analysis used a cohort of patients with Type 2 diabetes from the First Affiliated Hospital of Fujian Medical University. LAMM was defined using dual-energy X-ray absorptiometry-derived appendicular skeletal muscle mass index. Associations of clinically diagnosed DPN, LAMM, and their coexistence with osteoporosis, falls, and fractures were evaluated using logistic regression and Cox survival models. Exploratory serum antibody omics was performed.Results\n\nIn SHARE, grip strength was inversely associated with all three outcomes. In the local cohort, coexisting DPN and LAMM were associated with higher odds of osteoporosis (OR 2.151, 95% CI 1.645-2.805), falls (OR 4.667, 95% CI 3.406-6.376), and fractures (OR 2.416, 95% CI 1.367-3.515; all p < 0.001). Cox analyses showed higher hazards of osteoporosis (HR 3.410, 95% CI 1.579-7.362; p = 0.002) and falls (HR 4.385, 95% CI 1.838-10.459; p < 0.001), but not fractures (HR 0.708, 95% CI 0.187-2.675; p = 0.611). Antibody omics suggested a reactivity profile involving endoplasmic reticulum protein processing and neurodegeneration-related pathways.Conclusion\n\nCoexisting DPN and LAMM were associated with higher odds of all three skeletal outcomes and higher longitudinal hazards of osteoporosis and falls, but not fractures. The exploratory omics findings require functional validation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Endocrinology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.",
    "Department of Endocrinology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.",
    "Clinical Research Center for Metabolic Diseases of Fujian Province, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.",
    "Fujian Key Laboratory of Glycolipid and Bone Mineral Metabolism, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.",
    "Diabetes Research Institute of Fujian Province, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.",
    "Metabolic Diseases Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0,
        1,
        2,
        3,
        4,
        5
      ],
      "name": "Biao Zheng",
      "orcid": "0009-0006-1235-3550"
    },
    {
      "affs": [
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        1,
        2,
        3,
        4,
        5
      ],
      "name": "Yongze Zhang"
    },
    {
      "affs": [
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        2,
        3,
        4,
        5
      ],
      "name": "Dan Liang"
    },
    {
      "affs": [
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        2,
        3,
        4,
        5
      ],
      "name": "Ximei Shen",
      "orcid": "0000-0003-0598-366X"
    },
    {
      "affs": [
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        1,
        2,
        3,
        4,
        5
      ],
      "name": "Lingning Huang"
    },
    {
      "affs": [
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        1,
        2,
        3,
        4,
        5
      ],
      "name": "Fengying Zhao"
    },
    {
      "affs": [
        0,
        1,
        2,
        3,
        4,
        5
      ],
      "name": "Sunjie Yan",
      "orcid": "0000-0002-9695-1307"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0sqptc1159n6t.bib",
  "cited_by": 0,
  "doi": "10.1111/1753-0407.70276",
  "fulltext_url": "https://europepmc.org/articles/PMC13715079",
  "id": "0sqptc1159n6t",
  "issns": [
    "1753-0393",
    "1753-0407"
  ],
  "landing_url": "https://europepmc.org/article/MED/42949208",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2737|Nutrition and Health in Aging"
    ]
  ],
  "openalex": "W7224125509",
  "pdf_url": "https://europepmc.org/articles/PMC13715079?pdf=render",
  "pmcid": "PMC13715079",
  "pmid": "42949208",
  "published": "2026-10-28",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/0sqptc1159n6t.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:33Z",
      "native_id": "MED:42949208",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42949208"
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    {
      "first_seen": "2026-11-01T12:22:27Z",
      "native_id": "PMC13715079",
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      "url": "https://doi.org/10.1111/1753-0407.70276"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2737|Nutrition and Health in Aging",
      "subfield": "physiology"
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  ],
  "title": "Diabetic Peripheral Neuropathy With Low Appendicular Muscle Mass Is Associated With Osteoporosis, Falls, and Fractures.",
  "title_text": "Diabetic Peripheral Neuropathy With Low Appendicular Muscle Mass Is Associated With Osteoporosis, Falls, and Fractures.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:22:27Z",
  "url": "https://research.draconitic.com/paper/0sqptc1159n6t",
  "venue": "Journal of diabetes",
  "versions": []
}