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We did not observe cross-sectional associations between DII and the different BMD sites at baseline. In contrast, women and men ≥ 45years in the 25th quartile of changes in DII were associated with a gain of 0.067g/cm and 0.062g/cm of total hip BMD, while those in the 75th quartile of DII was associated with a reduction of - 0.108g/cm and - 0.100g/cm , respectively. These results were similar for femoral neck BMD in women. In contrast, we did not observe association with femoral neck BMD in men. We did not observe statistically significa