Abstract
AMI: There is growing evidence of a complex interaction between T2DM and osteoporosis. The purpose of this study was to further study the relationship between BTMs and fasting blood glucose (FBG) in postmenopausal patients with type 2 diabetes and to analyze the effect of hyperglycemia on bone metabolism. Methods: Six hundred and twelve (612) postmenopausal women were included, including one hundred and seven (107) subjects with T2DM and five hundred and five (505) subjects without diabetes. BMD was measured by DXA (dual-energy X-ray absorptiometry). Markers of bone formation (P1NP) and resorption ( CTX ) were quantified. Results: Compared to controls, postmenopausal women with diabetes had a higher prevalence of previous osteoporosis fracture (27.1% vs. 17.4% for diabetic and nondiabetic women, respectively) and a higher BMD. The P1NP level in women with T2DM was 49.451 ng/ml, while in N-DM individuals, it was 58.633 ng/ml, (p = 0.017). The CTX level in women with T2DM was 0.325 ng/ml, while in N-DM individuals, it was 0.412 ng/ml (p=0.039). In addition, P1NP was significantly negatively associated with age (β=-0.590; p= 0.002) and FBG (β=-1.950; p = 0.035). CTX was negatively associated with FBG (β=-0.029; p = 0.015). Conclusions: T2DM was associated with higher BMD and paradoxically, with an increased risk of fracture. Postmenopausal women with T2DM had lower bone turnover than controls. With increased levels of FBG, bone formation and bone resorption were reduced, and the overall bone turnover level was reduced. Keywords Type 2 diabetes mellitus · Bone mineral density · Bone turnover markers · Osteoporosis fracture