Associations of Bone Mineral Density and Bone Metabolism Indices with Urine Albumin to Creatinine Ratio in Chinese Patients with Type 2 Diabetes

2018 ◽  
Vol 6 (01) ◽  
pp. 50-55 ◽  
Author(s):  
Xin Zhao ◽  
Xiao-Mei Zhang ◽  
Ning Yuan ◽  
Xiao-Feng Yu ◽  
Li-Nong Ji
Keyword(s):  
Bone Mineral Density ◽  
Type 2 Diabetes ◽  
Diabetic Nephropathy ◽  
Bone Metabolism ◽  
Early Stage ◽  
Chinese Patients ◽  
Creatinine Ratio ◽  
Mineral Density ◽  
Urine Albumin

Abstract Objective To identify correlations of bone mineral density (BMD) and bone metabolism indices with the urine albumin to creatinine ratio (ACR) as an indicator of nephropathy in Chinese patients with type 2 diabetes (T2D). Methods In this retrospective analysis, 297 patients with T2D were divided into 3 groups according to the urine ACR. Patients’ data were analyzed to identify associations of general conditions, blood glucose level, lipid levels, and uric acid level with BMD and bone metabolism indices. Results BMD at every location tested (femoral neck, trochanter, inside hip, Ward’s triangle, total hip, and lumbar vertebrae) was negatively correlated with the urine ACR (all p<0.05). Osteocalcin, beta-C-terminal telopeptide (β-CTX), and procollagen type 1 N- peptide (P1NP) were positively correlated with urine ACR (all p<0.05). Finally, 25-hydroxyvitamin D [25(OH)D] was negatively correlated with urine ACR (p<0.05). Multiple regression analysis with adjustment for age, body mass index, disease duration, and other clinical measurements revealed no significant correlation between urine ACR and BMD measurements or β-CTX (p>0.05). However, significant correlations remained between urine ACR and osteocalcin, P1NP, and 25(OH)D (p<0.05). The same results were obtained for postmenopausal women specifically, with the exception of a significant correlation between the ACR and β-CTX (p<0.05). Conclusion In the early stage of diabetic nephropathy, BMD changes and bone transformation acceleration may occur, and the acceleration of bone transformation may occur before the change in BMD. Therefore, it is important to monitor bone metabolism indices in the early stage of diabetic nephropathy in T2D patients.

Usefulness of measuring urine neutrophil gelatinase-associated lipocalin (NGAL) and calculating NGAL to creatinine ratio as early predictors of kidney dysfunction in patients with type 2 diabetes

2015 ◽  
Vol 51 (2) ◽  
pp. 97-104
Author(s):  
Agnieszka Gala-Błądzińska ◽  
Agnieszka Żyłka ◽  
Katarzyna Rybak ◽  
Paulina Dumnicka ◽  
Marek Kuźniewski ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Ldl Cholesterol ◽  
Early Stage ◽  
Control Group ◽  
Creatinine Ratio ◽  
Kidney Dysfunction ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Urine Albumin ◽  
Positive Correlations

The aim of the study was to assess the usefulness of measuring concentrations of NGAL in first morning urine and calculating NGAL/creatinine ratio (uNGAL/uCr) among patients with early stage diabetic kidney disease (DKD) in course of type 2 diabetes (DMt2) and to assess the correlations between these markers and routine biochemical and blood count parameters. Material and Methods: The studied group consisted of 55 patients with DKD in course of DMt2 and 22 controls without diabetes; the study included patients with estimated glomerular filtration rate >60ml/min/1,73m2 without overt proteinuria. NGAL was measured with chemiluminescence microparticle immunoassay (CMIA) with ARCHITECT analyzer (Abbott Diagnostics). Results: Studied group had higher values of uNGAL/uCr than controls (median 21.3 vs. 12.2 μg/g; p=0.014). Among studied group, women presented higher uNGAL/uCr comparing to men (38.6 vs. 11.7 μg/g; p=0.001). Both in patients and controls, uNGAL concentrations were positively correlated with urine creatinine. In studied group, we observed positive correlations of uNGAL and uNGAL/uCr with urine albumin and albumin/creatinine retaio (UACR); in control group, only the correlation between uNGAL and albuminuria was statistically significant. Additionally, in studied group, positive correlations were observed between uNGAL and uNGAL/uCr and serum cholesterol, LDL-cholesterol and triglycerides concentrations. In multiple regression, albuminuria and LDL-cholesterol significantly predicted uNGAL and UACR and triglycerides significantly predicted uNGAL/uCr in the studied group. Conclusions: The obtained results confirm the usefulness of measuring uNGAL and calculating uNGAL/uCr as early markers of kidney dysfunction in patients with DMt2. The results of the study should be confirmed in larger group of patients.

Bone Mineral Density and its Related Factors in Elderly Male Chinese Patients with Type 2 Diabetes

2007 ◽  
Vol 38 (2) ◽  
pp. 259-264 ◽  
Author(s):  
Ling Xu ◽  
Mei Cheng ◽  
Xiangqun Liu ◽  
Peiyan Shan ◽  
Haiqing Gao
Keyword(s):  
Bone Mineral Density ◽  
Type 2 Diabetes ◽  
Bone Mineral ◽  
Chinese Patients ◽  
Mineral Density ◽  
Elderly Male ◽  
Related Factors

scholarly journals The influence of glycemic control on bone mineral density and bone metabolism in patients with Type 2 Diabetes Mellitus

2016 ◽  
Author(s):  
Eleftheria Barmpa ◽  
Spyros Karamagiolis ◽  
Stelios Tigas ◽  
Parthena Navrozidou ◽  
Marianna Vlychou ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Bone Mineral Density ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Bone Metabolism ◽  
Bone Mineral ◽  
Mineral Density

scholarly journals Bone mineral density and bone metabolism in postmenopausal women with type 2 diabetes in a Chinese community: a cross-sectional study

2020 ◽  
Author(s):  
Wu Han ◽  
Yufan Zhang ◽  
Wenbin Zhou ◽  
Jing Dai ◽  
Tao Yao ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Type 2 Diabetes ◽  
Bone Formation ◽  
Bone Turnover ◽  
Bone Metabolism ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Mineral Density ◽  
Osteoporosis Fracture

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

scholarly journals Bone mineral density and bone metabolism in postmenopausal women with type 2 diabetes in a Chinese community: a cross-sectional study

2020 ◽  
Author(s):  
Wu Han ◽  
Yufan Zhang ◽  
Wenbin Zhou ◽  
Guolong Zhang ◽  
Jindi Wang ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Type 2 Diabetes ◽  
Bone Formation ◽  
Bone Turnover ◽  
Bone Metabolism ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Mineral Density ◽  
Negatively Associated

Abstract Background: There is growing evidence of a complex interaction between type 2 diabetes (T2DM) and osteoporosis. The purpose of this study was to further study the relationship between Bone turnover markers (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. Bone mineral density (BMD) was measured by DXA (dual-energy X-ray absorptiometry). Markers of bone formation Type 1 collagen N-terminal peptide (P1NP) and resorption C-telopeptide of type l collagen (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.

MO645BONE MINERAL DENSITY IN POSTMENOPAUSAL WOMEN WITH TYPE 2 DIABETES MELLITUS WITH AND WITHOUT DIABETIC NEPHROPATHY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Daniela Valentinova Monova ◽  
Russka Shumnalieva ◽  
Simeon Monov
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Lumbar Spine ◽  
Postmenopausal Women ◽  
Mineral Density ◽  
Urine Albumin Excretion ◽  
Urine Albumin

Abstract Background and Aims Diabetes mellitus and osteoporosis are both common human diseases. Diabetic nephropathy is characterized by the presence of pathological quantities of urine albumin excretion, diabetic glomerular lesions, and loss of glomerular filtration rate in diabetics. Little evidence has been reported on relationships between BMD and albuminuria. The aim of this study is to compare the bone mineral density (BMD) in postmenopausal women with type 2 diabetes mellitus (T2DM) with and without diabetic nephropathy. Method We retrospectively analyze the BMD of the lumbar spine and femur using dual-energy X-ray absorptiometry in 84 postmenopausal women with T2DM with (39) and without (45) diabetic nephropathy. The serum levels of calcium, phosphorus, total alkaline phosphatase, and urine albumin excretion were measured in all participants. Diagnosis of albuminuria was based on albumin-creatinine ratio (ACR). Results Age, body mass index (BMI) and time since menopause were not significantly different between the two groups. The T-scores of basal BMD at L4 were significantly lower in patients with diabetic nephropathy (-0,94 ± 0,40) compared to patients without nephropathy. No significant differences in serum creatinine were detected between two groups of patients. Our data suggest that ACR was negatively associated with lumbar spine and femoral neck BMD. Conclusion Our results suggest that postmenopausal women with diabetic nephropathy have a lower BMD and are at increased risk of osteoporosis in the lumbar spine compared with postmenopausal women without diabetic nephropathy. ACR was negatively associated with lumbar spine and femur neck BMD. One of the explanations that has been proposed for the association between albuminuria and osteoporosis is that albuminuria is associated with reduced bone blood flow, resulting in a decreased rate of bone remodeling and the development of osteoporosis.

scholarly journals Effects of vitamin D combined with pioglitazone hydrochloride on bone mineral density and bone metabolism in Type 2 diabetic nephropathy

2017 ◽  
Vol 37 (2) ◽  
Author(s):  
Ling-Xu Wang ◽  
Na Wang ◽  
Qing-Li Xu ◽  
Wei Yan ◽  
Li Dong ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Diabetic Nephropathy ◽  
Bone Metabolism ◽  
Bone Mineral ◽  
Type I ◽  
Mineral Density ◽  
Blood Calcium ◽  
Type 2 Diabetic

The study aims to investigate the effect of vitamin D (VD) combined with pioglitazone hydrochloride (PIO) on bone mineral density (BMD) and bone metabolism in patients with Type 2 diabetic nephropathy (T2DN). T2DN patients were selected and assigned into mild, moderate, and severe groups. In each group, three therapy regimens (VD, PIO, and VD plus PIO) were administered. X-ray absorptiometry was used to measure BMD. Intact parathyroid hormone (iPTH) and 25-hydroxyvitamin D3 (25-OH-VD3) were measured by chemiluminescence meter. ELISA was applied to detect levels of osteoprotegerin (OPG), bone gla protein (BGP), C-terminal telopeptides of type I collagen (β-CTX), procollagen type I N-propeptide (PINP), pyridinoline (Pyr), and deoxypyridinoline (D-Pyr). Compared with the mild group, T2DN patients in the moderate and severe groups had longer course of disease and higher levels of total cholesterol (TC), triglyceride (TG), serum phosphorus, fasting plasma glucose (FPG), glycosylated hemoglobin (HbAlc) and creatine (Cr), and lower blood calcium. The BMD in different parts increased among the mild, moderate, and severe groups, and the highest BMD was found after VD plus PIO treatment. OPG, iPTH, BGP, β-CTX, Pyr/Cr, and D-Pyr/Cr levels were reduced, while 25-OH-VD3 and PINP levels were elevated among three groups after different treatments, and the most obvious change was observed after VD plus PIO treatment. Our findings indicate that VD combined with PIO may be more effective in improving BMD and bone metabolism than VD or PIO alone in the treatment of T2DN patients, especially for T2DN patients with mild disease.

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