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Aim: Patients with type 2 diabetes (T2DM) have more risk of bone fractures. However, areal bone mineral density (aBMD) by conventional dual-energy xray absorptiometry (DXA) is not useful for identifying this risk. This study aims to evaluate 3D-DXA parameters determining the cortical and trabecular compartments in patients with T2DM compared to non-diabetic subjects and to identify their determinants. Materials and methods: Case-control study in 111 T2DM patients (65.4 ± 7.6 years old) and 134 non-diabetic controls (64.7 ± 8.6-year-old). DXA, 3D-DXA modelling via 3D-Shaper software and trabecular bone score (TBS) were used to obtain aBMD, cortical and trabecular parameters, and lumbar spine microarchitecture, respectively. In addition, biochemical markers as 25- hydroxyvitamin d, type I procollagen N-terminal propeptide (P1NP), Cterminal telopeptide of type I collagen (CTX), and glycated haemoglobin (HbA1c) were analysed. Results: Mean-adjusted values showed higher aBMD (5.4%-7.7%, ES: 0.33- 0.53) and 3D-DXA parameters (4.1%-10.3%, ES: 0.42-0.68) in the T2DM group compared with the control group. However, TBS was lower in the T2DM group compared to the control group (-14.7%, ES: 1.18). In addition, sex (b = 0.272 to 0.316) and body mass index (BMI) (b = 0.236 to 0.455) were the most consistent and positive predictors of aBMD (p ≤ 0.01). BMI and P1NP were negative predictors of TBS (b = -0.530 and -0.254, respectively, p ≤ 0.01), while CTX was a positive one (b = 0.226, p=0.02). Finally, BMI was consistently the strongest positive predictor of 3D-DXA parameters (b = 0.240 to 0.442, p, Instituto de Salud Carlos III grants (PI18–00803, PI21–01069, and PI18–01235), European Regional Development Fund (FEDER) Junta de Andalucı́a grant (PI-0268–2019), Programa Operativo Fondo Social Europeo (FSE) de Andalucı́a (2014–2020) DOC_01618, Instituto de Salud Carlos III (CD20/00022)

Background: The possibility of carrying out screening, with acceptable accuracy, of a child’s bone mass status based on a physical fitness test can advance the concept of health-related physical fitness. In addition, the relevance of the applicability of this type of screening in educational environments is mainly due to the difficulty of direct assessments of bone health indicators. This study aimed to propose cut-off points for physical fitness tests based on children’s bone health indicators.Methods: This is a two-phase cross-sectional study. Phase-1: 160 children (6–11 years-old) performed the 20-m sprint test (20-mST) and the 2 kg medicine ball throw test (2 kgMBTT). Areal bone mineral density (aBMD) and content was assessed by DXA. The area under the ROC curve greater than 70% was considered valid. Phase-2: It was carried out a secondary analysis in a sample with 8,750 Brazilians (6–11 years-old). The percentile values (identified in phase-1) were used to identify the values of the cut-off points in the unit of measurement of the tests. The validation of the cut-off points found was by odds ratio values and p ≤ 0.05.Results: Phase 1: The areas under the ROC curve were 0.710, 0.712 (boys and girls–20-mST), 0.703, and 0.806 (boys and girls–2 kgMBTT) with total spine and pelvis aBMD as the outcome. Phase 2: From percentile values, we find valid cut-off points in the Brazilian sample (OR > 3.00; p < 0.001) for boys and girls. Values ranged between 5.22 s–4.00 s to 20-mST and between 125.0 cm–160.0 cm to 2 kgMBTT. Conclusion. The 20-mST and the 2 kgMBTT presented sufficient accuracy for the screening of children aged between 6 and 11 years with greater chances of having low aBMD in the total spine and pelvis, with valid cut-off points.