Plasma sTWEAK, diabetes mellitus, and bone fractures in postmenopausal women

Cytokines, such as tumor necrosis factor alpha (TNFα) and TNF-like weak inducer of apoptosis (TWEAK), may have pivotal roles in regulating bone remodeling in osteoporosis. Therefore, this study aims to investigate the potential association between plasma sTWEAK levels and bone fractures in diabetes mellitus (DM) and postmenopausal conditions. A nested case–control study was conducted within a cohort comprising 1057 postmenopausal women in Santa Maria. We analyzed 52 subjects who reported major bone fractures (defined as hip, forearm, humerus, or clinical vertebral fractures occurring after the age of 45 years, excluding high-impact fractures) and 110 subjects who did not experience fractures. Participants completed a questionnaire regarding clinical data, and anthropometric evaluations were conducted. Blood samples were collected for biochemical profiling, and sTWEAK plasma concentrations were determined via enzyme-linked immunosorbent assay (ELISA). Logarithmic transformation was applied to asymmetric variables. Student's t-test or Mann–Whitney test was utilized to compare data between two groups, while ANOVA or Chi-square test was employed for comparisons involving more than two groups. Diabetic subjects exhibited lower plasma levels of sTWEAK (p = 0.002). However, no significant differences were observed concerning the presence of bone fractures. Plasma levels of sTWEAK were not found to be associated with bone fragility in postmenopausal women. Nonetheless, reduced plasma levels of this cytokine were linked to diabetes mellitus.