Research Article
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Year 2023, Volume: 9 Issue: 2, 301 - 308, 04.03.2023
https://doi.org/10.18621/eurj.1085838

Abstract

References

  • 1. Hu Y, Li X, Yan X, Huang G, Dai R, Zhou Z. Bone mineral density spectrum in individuals with type 1 diabetes, latent autoimmune diabetes in adults, and type 2 diabetes. Diabetes Metab Res Rev 2021;37:e3390.
  • 2. Li J, Li C. Relationship between abnormal glucose metabolism and osteoporosis in Han Chinese men over the age of 50 years. Clin Interv Aging 2019;14:445-51.
  • 3. Zhao C, Liu G, Zhang Y, Xu G, Yi X, Liang J, et al. Association between serum levels of bone turnover markers and bone mineral density in men and women with type 2 diabetes mellitus. J Clin Lab Anal 2020;34:e23112.
  • 4. Auwerx J, Dequeker J, Bouillon R, Geusens P, Nijs J. Mineral metabolism and bone mass at peripheral and axial skeleton in diabetes mellitus. Diabetes 1988;37:8-12.
  • 5. Gregorio F, Cristallini S, Santeosanio F, Filipponi P, Fumelli P. Osteopenia associated with non-insulin-dependent diabetes mellitus: what are the causes? Diabetes Res Clin Pract 1994;40:75-9.
  • 6. Zhang YX, Min SX. [Analysis of clinical factors correlating with osteoporosis in patients with type 2 diabetes mellitus]. Nan Fang Yi Ke Da Xue Xue Bao 2016;36:1546-9. [Article in Chinese]
  • 7. Yao X, Xu X, Jin F, Zhu Z. The correlation of type 2 diabetes status with bone mineral density in middle-aged adults. Diabetes Metab Syndr Obes 2020;13:3269-76.
  • 8. Miyake H, Kanazawa I, Sugimoto T. Association of Bone Mineral Density, Bone Turnover Markers, and Vertebral Fractures with All-Cause Mortality in Type 2 Diabetes Mellitus. Calcif Tissue Int 2018;102:1-13.
  • 9. Yamamoto M, Yamaguchi T, Nawata K, Yamauchi M, Sugimoto T. Decreased PTH levels accompanied by low bone formation are associated with vertebral fractures in postmenopausal women with type 2 diabetes. J Clin Endocrinol Metab 2012;97:1277-84.
  • 10. Pedrazzoni M, Ciotti G, Pioli G, Girasole G, Davoli L, Palummeri E, Passeri M. Osteocalcin levels in diabetic subjects. Calcif Tissue Int 1989;45:331-6.
  • 11. Paschou SA, Dede AD, Anagnostis PG, Vryonidou A, Morganstein D, Goulis DG. Type 2 diabetes and osteoporosis: a guide to optimal management. J Clin Endocrinol Metab 2017;102:3621-34.
  • 12. Dede AD, Tournis S, Dontas I, Trovas G. Type 2 diabetes mellitus and fracture risk. Metabolism 2014;63:1480-90.
  • 13. Xu H, Wang Z, Li X, Fan M, Bao C, Yang R, et al. Osteoporosis and osteopenia among patients with type 2 diabetes aged ≥50: role of sex and clinical characteristics. J Clin Densitom 2020;23:29-36.
  • 14. Compston J. Type 2 diabetes mellitus and bone. J Intern Med 2018;283:140-53.
  • 15. Tibi L, Collier A, Patrick AW, Clarke BF, Smith AF. Plasma alkaline phosphatase isoenzymes in diabetes mellitus. Clinica Chimica Acta 1988;177:147-56.
  • 16. Cloos C, Wahl P, Hasslacher C, Traber L, Kistner M, Jurkuhn K, et al. Urinary glycosylated, free and total pridinoline and free and total deoxypyridinoline in diabetes mellitus. Clin Endocrinol (Oxf) 1998;48:317-23.
  • 17. Suh S, Bae JC, Jin SM, Jee JH, Park MK, Kim DK, et al. Serum calcium changes and risk of type 2 diabetes mellitus in Asian population. Diabetes Res Clin Pract 2017;133:109-14.
  • 18. Shahwan MJ, Khattab MH, Jairoun AA. Association of serum calcium level with waist circumference and other biochemical health-care predictors among patients with type 2 diabetes. J Pharm Bioallied Sci 2019;11:292-8.
  • 19. Hough S, Russel JE, Teitelbaum SL, Avioli LV. Calcium homeostasis in chronic streptozotosin-induced diabetes mellitus in the rat. Am J Physiol 1983;242:E451-6.
  • 20. Cole DEC, Carpenter TO, Gundberg CM. Serum osteocalcin concentrations in children with metabolic bone disease. J Pediatr 1985;106:770-6.
  • 21. Hauscka P, Lian JB, Cole DEC, Gundberg CM. Osteocalcin and matrix Gla protein: Vitamin K dependent proteins in bone. Physiol Rev 1989;69:990-1046.
  • 22. Li Y, Chen JP, Duan L, Li S. Effect of vitamin K2 on type 2 diabetes mellitus: a review. Diabetes Res Clin Pract 2018;136:39-51.
  • 23. Bora K, Ruram AA. No association of 25-hydroxyvitamin D and parathormone levels with glucose homeostasis in type 2 diabetes - a study from Shillong, Meghalaya. Int J Vitam Nutr Res 2019;89:285-92.
  • 24. Dhaliwal R, Cibula D, Ghosh C, Weinstock RS, Moses AM. Bone quality assessment in type 2 diabetes mellitus. Osteoporos Int 2014;25:1969-73.

Bone turnover markers and bone mineral density in patients with type 2 diabetes

Year 2023, Volume: 9 Issue: 2, 301 - 308, 04.03.2023
https://doi.org/10.18621/eurj.1085838

Abstract

Background: This study was designed in order to evaluate bone and mineral metabolism in type 2 diabetic patients and its relationship with bone mineral density and diabetic microvascular complications.


Methods:
Forty two type 2 diabetic patients and 23 healthy cases were included in the study. Serum osteocalcin, procollagen type 1 – C peptide (PICP), total and bone specific alkaline phosphatase (bone ALP), urinary deoxypyridinoline (free DPD), parathormone (PTH), serum and urinary calcium and phosphorus levels were measured. Bone mineral densities of all subjects were studied in lumbar vertebra and femur region using dual X-ray absorptiometry (DXA).


Results:
Serum osteocalcin and bone ALP levels of the diabetics were found to be significantly lower and total alkaline phosphatase and calcium levels were higher in diabetic patients compared to healthy controls, but PICP and free DPD levels were not different between these two groups. There was a positive correlation between PTH levels and urinary DPD excretion. Among diabetics, serum osteocalcin levels increased with the impairment of renal functions. Bone mineral densities were lower in diabetics with worse renal functions.

Conclusion: Bone turnover is slow in type 2 diabetes and there is no prominent bone loss related to this condition. PTH is an important factor determining the rate of bone resorption in diabetics. Renal functional impairment is the most important factor affecting the bone mass in type 2 diabetic patients.

References

  • 1. Hu Y, Li X, Yan X, Huang G, Dai R, Zhou Z. Bone mineral density spectrum in individuals with type 1 diabetes, latent autoimmune diabetes in adults, and type 2 diabetes. Diabetes Metab Res Rev 2021;37:e3390.
  • 2. Li J, Li C. Relationship between abnormal glucose metabolism and osteoporosis in Han Chinese men over the age of 50 years. Clin Interv Aging 2019;14:445-51.
  • 3. Zhao C, Liu G, Zhang Y, Xu G, Yi X, Liang J, et al. Association between serum levels of bone turnover markers and bone mineral density in men and women with type 2 diabetes mellitus. J Clin Lab Anal 2020;34:e23112.
  • 4. Auwerx J, Dequeker J, Bouillon R, Geusens P, Nijs J. Mineral metabolism and bone mass at peripheral and axial skeleton in diabetes mellitus. Diabetes 1988;37:8-12.
  • 5. Gregorio F, Cristallini S, Santeosanio F, Filipponi P, Fumelli P. Osteopenia associated with non-insulin-dependent diabetes mellitus: what are the causes? Diabetes Res Clin Pract 1994;40:75-9.
  • 6. Zhang YX, Min SX. [Analysis of clinical factors correlating with osteoporosis in patients with type 2 diabetes mellitus]. Nan Fang Yi Ke Da Xue Xue Bao 2016;36:1546-9. [Article in Chinese]
  • 7. Yao X, Xu X, Jin F, Zhu Z. The correlation of type 2 diabetes status with bone mineral density in middle-aged adults. Diabetes Metab Syndr Obes 2020;13:3269-76.
  • 8. Miyake H, Kanazawa I, Sugimoto T. Association of Bone Mineral Density, Bone Turnover Markers, and Vertebral Fractures with All-Cause Mortality in Type 2 Diabetes Mellitus. Calcif Tissue Int 2018;102:1-13.
  • 9. Yamamoto M, Yamaguchi T, Nawata K, Yamauchi M, Sugimoto T. Decreased PTH levels accompanied by low bone formation are associated with vertebral fractures in postmenopausal women with type 2 diabetes. J Clin Endocrinol Metab 2012;97:1277-84.
  • 10. Pedrazzoni M, Ciotti G, Pioli G, Girasole G, Davoli L, Palummeri E, Passeri M. Osteocalcin levels in diabetic subjects. Calcif Tissue Int 1989;45:331-6.
  • 11. Paschou SA, Dede AD, Anagnostis PG, Vryonidou A, Morganstein D, Goulis DG. Type 2 diabetes and osteoporosis: a guide to optimal management. J Clin Endocrinol Metab 2017;102:3621-34.
  • 12. Dede AD, Tournis S, Dontas I, Trovas G. Type 2 diabetes mellitus and fracture risk. Metabolism 2014;63:1480-90.
  • 13. Xu H, Wang Z, Li X, Fan M, Bao C, Yang R, et al. Osteoporosis and osteopenia among patients with type 2 diabetes aged ≥50: role of sex and clinical characteristics. J Clin Densitom 2020;23:29-36.
  • 14. Compston J. Type 2 diabetes mellitus and bone. J Intern Med 2018;283:140-53.
  • 15. Tibi L, Collier A, Patrick AW, Clarke BF, Smith AF. Plasma alkaline phosphatase isoenzymes in diabetes mellitus. Clinica Chimica Acta 1988;177:147-56.
  • 16. Cloos C, Wahl P, Hasslacher C, Traber L, Kistner M, Jurkuhn K, et al. Urinary glycosylated, free and total pridinoline and free and total deoxypyridinoline in diabetes mellitus. Clin Endocrinol (Oxf) 1998;48:317-23.
  • 17. Suh S, Bae JC, Jin SM, Jee JH, Park MK, Kim DK, et al. Serum calcium changes and risk of type 2 diabetes mellitus in Asian population. Diabetes Res Clin Pract 2017;133:109-14.
  • 18. Shahwan MJ, Khattab MH, Jairoun AA. Association of serum calcium level with waist circumference and other biochemical health-care predictors among patients with type 2 diabetes. J Pharm Bioallied Sci 2019;11:292-8.
  • 19. Hough S, Russel JE, Teitelbaum SL, Avioli LV. Calcium homeostasis in chronic streptozotosin-induced diabetes mellitus in the rat. Am J Physiol 1983;242:E451-6.
  • 20. Cole DEC, Carpenter TO, Gundberg CM. Serum osteocalcin concentrations in children with metabolic bone disease. J Pediatr 1985;106:770-6.
  • 21. Hauscka P, Lian JB, Cole DEC, Gundberg CM. Osteocalcin and matrix Gla protein: Vitamin K dependent proteins in bone. Physiol Rev 1989;69:990-1046.
  • 22. Li Y, Chen JP, Duan L, Li S. Effect of vitamin K2 on type 2 diabetes mellitus: a review. Diabetes Res Clin Pract 2018;136:39-51.
  • 23. Bora K, Ruram AA. No association of 25-hydroxyvitamin D and parathormone levels with glucose homeostasis in type 2 diabetes - a study from Shillong, Meghalaya. Int J Vitam Nutr Res 2019;89:285-92.
  • 24. Dhaliwal R, Cibula D, Ghosh C, Weinstock RS, Moses AM. Bone quality assessment in type 2 diabetes mellitus. Osteoporos Int 2014;25:1969-73.
There are 24 citations in total.

Details

Primary Language English
Subjects Endocrinology
Journal Section Original Articles
Authors

Aysen Akalın 0000-0003-3550-2871

Göknur Yorulmaz 0000-0001-8596-9344

İ. Özkan Alataş 0000-0002-1753-8873

Kevser Onbaşı 0000-0003-2230-9263

Fatma Belgin Efe 0000-0002-1976-6060

Publication Date March 4, 2023
Submission Date March 10, 2022
Acceptance Date March 29, 2022
Published in Issue Year 2023 Volume: 9 Issue: 2

Cite

AMA Akalın A, Yorulmaz G, Alataş İÖ, Onbaşı K, Efe FB. Bone turnover markers and bone mineral density in patients with type 2 diabetes. Eur Res J. March 2023;9(2):301-308. doi:10.18621/eurj.1085838

e-ISSN: 2149-3189 


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