Different health behaviours and clinical factors associated with bone mineral density and bone turnover in premenopausal women with and without type 1 diabetes

Background There is substantial evidence that adults with type 1 diabetes have reduced bone mineral density (BMD), however findings in youth are inconsistent. Purpose Systematic review and meta-analysis of BMD in youth with type 1 diabetes using multiple modalities: dual energy X-ray absorptiometry (DXA), peripheral quantitative computed tomography (pQCT) and/or quantitative ultrasound (QUS). Data Sources PubMed, Embase, Scopus and Web of Science from 01/01/1990 to 31/12/2020, limited to humans, without language restriction. Study Selection Inclusion criteria: cross sectional or cohort studies that included BMD measured either by DXA, pQCT and/or QUS in youth (age <20 years) with type 1 diabetes and matched controls. Data extraction Total body (TB), lumbar spine (LS) and femoral BMD (DXA); tibia, radius and lumbar spine (pQCT); and phalanx and calcaneum (QUS). Weighted mean difference (WMD) or standardized mean difference (SMD) were estimated and meta-regression was performed using age, diabetes duration and HbA1c as covariates. Data Synthesis We identified 1300 non-duplicate studies; 46 met the inclusion criteria, including 2617 cases and 3851 controls. Mean age was 12.6 ± 2.3 years. Youth with type 1 diabetes had lower BMD: TB (WMD -0.04 g/cm2, 95% CI -0.06 to -0.02, P=0.0006); LS (-0.02 g/cm2, -0.03 to -0.0, P = 0.01); femur (-0.04 g/cm2, -0.05 to -0.03, P<0.00001); tibial trabecular (-11.32 g/cm3,-17.33 to -5.30, P=0.0002), radial trabecular (-0.91, -1.55 to -0.27, P=0.005); phalangeal (-0.32, -0.38 to -0.25, P<0.00001) and calcaneal (SMD -0.69, -1.11 to -0.26, P=0.001). Using meta-regression TB BMD was associated with older age (coefficient -0.0063, -0.0095 to -0.0031, P=0.002), but not longer diabetes duration or HbA1c. Limitations Meta-analysis was limited by the small number of studies using QUS and pQCT and lack of use BMD z-scores in all studies. Conclusions Bone development is abnormal in youth with type 1 diabetes, assessed by multiple modalities. Routine assessment of BMD should be considered in all youth with type 1 diabetes.

Download Full-text

Bone Turnover and Bone Mineral Density Are Independently Related to Selenium Status in Healthy Euthyroid Postmenopausal Women

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2012-2121 ◽

2012 ◽

Vol 97 (11) ◽

pp. 4061-4070 ◽

Cited By ~ 40

Author(s):

Antonia Hoeg ◽

Apostolos Gogakos ◽

Elaine Murphy ◽

Sandra Mueller ◽

Josef Köhrle ◽

...

Keyword(s):

Bone Mineral Density ◽

Bone Turnover ◽

Postmenopausal Women ◽

Bone Mineral ◽

Selenoprotein P ◽

Selenium Status ◽

Mineral Density ◽

Thyroid Status ◽

Hip Bmd

Context: Selenium status may have direct effects on bone and indirect effects through changes in thyroid hormone sensitivity. Objective: We hypothesized that variation in selenium status in healthy euthyroid postmenopausal women is associated with differences in bone turnover, bone mineral density (BMD) and fracture susceptibility. Design: The Osteoporosis and Ultrasound Study (OPUS) is a 6-yr prospective study of fracture-related factors. Setting: The study was comprised of a population-based cohort from five European cities. Participants: A total of 2374 postmenopausal women participated. Subjects with thyroid disease and nonthyroidal illness and those receiving drugs affecting thyroid status or bone metabolism were excluded, leaving a study population of 1144. Interventions: There were no interventions. Main Outcome Measures: We measured selenium (micrograms per liter); selenoprotein P (milligrams per liter); free T4 (picomoles per liter); free T3 (picomoles per liter); TSH (milliunits per liter); bone turnover markers; BMD; and vertebral, hip, and nonvertebral fractures. Results: Higher selenium levels were associated with higher hip BMD at study entry (β = 0.072, P = 0.004) and lower levels of bone formation (osteocalcin: β = −0.101, P < 0.001; procollagen type 1 N-terminal propeptide: β = −0.074, P = 0.013) and resorption markers (C-telopeptide of type 1 collagen: β = −0.058, P = 0.050; N-telopeptide of type 1 collagen: β = −0.095, P = 0.002). Higher selenoprotein P was associated with higher hip (β = 0.113, P < 0.001) and lumbar spine BMD (β = 0.088, P = 0.003) at study entry, higher hip BMD after the 6-yr follow-up (β = 0.106, P = 0.001) and lower osteocalcin (β = −0.077, P = 0.009), C-telopeptide of type 1 collagen (β = −0.075, P = 0.012), and N-telopeptide of type 1 collagen (β = −0.110, P < 0.001). Conclusion: Selenium status is inversely related to bone turnover and positively correlated with BMD in healthy euthyroid postmenopausal women independent of thyroid status.

Download Full-text

Faculty Opinions recommendation of Bone Mineral Density and Type 1 Diabetes in Children and Adolescents: A Meta-analysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.740512255.793588285 ◽

2021 ◽

Author(s):

Madhusmita Misra

Keyword(s):

Bone Mineral Density ◽

Type 1 Diabetes ◽

Children And Adolescents ◽

Bone Mineral ◽

Meta Analysis ◽

Mineral Density

Download Full-text

Serum Levels of miR-148a and miR-21-5p Are Increased in Type 1 Diabetic Patients and Correlated with Markers of Bone Strength and Metabolism

Non-Coding RNA ◽

10.3390/ncrna4040037 ◽

2018 ◽

Vol 4 (4) ◽

pp. 37 ◽

Cited By ~ 15

Author(s):

Giuseppina E. Grieco ◽

Dorica Cataldo ◽

Elena Ceccarelli ◽

Laura Nigi ◽

Giovanna Catalano ◽

...

Keyword(s):

Bone Mineral Density ◽

Type 1 Diabetes ◽

Bone Loss ◽

Bone Metabolism ◽

Bone Remodeling ◽

Bone Mineral ◽

Bone Fragility ◽

Bone Homeostasis ◽

Mineral Density

Type 1 diabetes (T1D) is characterized by bone loss and altered bone remodeling, resulting into reduction of bone mineral density (BMD) and increased risk of fractures. Identification of specific biomarkers and/or causative factors of diabetic bone fragility is of fundamental importance for an early detection of such alterations and to envisage appropriate therapeutic interventions. MicroRNAs (miRNAs) are small non-coding RNAs which negatively regulate genes expression. Of note, miRNAs can be secreted in biological fluids through their association with different cellular components and, in such context, they may represent both candidate biomarkers and/or mediators of bone metabolism alterations. Here, we aimed at identifying miRNAs differentially expressed in serum of T1D patients and potentially involved in bone loss in type 1 diabetes. We selected six miRNAs previously associated with T1D and bone metabolism: miR-21; miR-24; miR-27a; miR-148a; miR-214; and miR-375. Selected miRNAs were analyzed in sera of 15 T1D patients (age: 33.57 ± 8.17; BMI: 21.4 ± 1.65) and 14 non-diabetic subjects (age: 31.7 ± 8.2; BMI: 24.6 ± 4.34). Calcium, osteocalcin, parathormone (PTH), bone ALkaline Phoshatase (bALP), and Vitamin D (VitD) as well as main parameters of bone health were measured in each patient. We observed an increased expression of miR-148a (p = 0.012) and miR-21-5p (p = 0.034) in sera of T1D patients vs non-diabetic subjects. The correlation analysis between miRNAs expression and the main parameters of bone metabolism, showed a correlation between miR-148a and Bone Mineral Density (BMD) total body (TB) values (p = 0.042) and PTH circulating levels (p = 0.033) and the association of miR-21-5p to Bone Mineral Content-Femur (BMC-FEM). Finally, miR-148a and miR-21-5p target genes prediction analysis revealed several factors involved in bone development and remodeling, such as MAFB, WNT1, TGFB2, STAT3, or PDCD4, and the co-modulation of common pathways involved in bone homeostasis thus potentially assigning a role to both miR-148a and miR-21-5p in bone metabolism alterations. In conclusion, these results lead us to hypothesize a potential role for miR-148a and miR-21-5p in bone remodeling, thus representing potential biomarkers of bone fragility in T1D.

Download Full-text