Low serum levels of bone turnover markers are associated with the presence and severity of diabetic retinopathy in patients with type 2 diabetes mellitus

Background Obesity is known as a common risk factor for osteoporosis and type 2 diabetes mellitus (T2DM). Perirenal fat, surrounding the kidneys, has been reported to be unique in anatomy and biological functions. This study aimed to explore the relationship between perirenal fat and bone metabolism in patients with T2DM. Methods A total of 234 patients with T2DM were recruited from September 2019 to December 2019 in the cross-sectional study. The biochemical parameters and bone turnover markers (BTMs) were determined in all participants. Perirenal fat thickness (PrFT) was performed by ultrasounds via a duplex Doppler apparatus. Associations between PrFT and bone metabolism index were determined via correlation analysis and regression models. Results The PrFT was significantly correlated with β-C-terminal telopeptides of type I collagen (β-CTX) (r = −0.14, P < 0.036), parathyroid hormone (iPTH) (r = −0.18, P ≤ 0.006), and 25 hydroxyvitamin D (25-OH-D) (r = −0.14, P = 0.001). Multivariate analysis confirmed that the association of PrFT and β-CTX (β = −0.136, P = 0.042) was independent of other variables. Conclusion This study showed a negative and independent association between PrFT and β-CTX in subjects with T2DM, suggesting a possible role of PrFT in bone metabolism. Follow-up studies and further research are necessary to validate the associations and to elucidate the underlying mechanisms.

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Hemoglobin A1c Threshold for Reduction in Bone Turnover in Men With Type 2 Diabetes Mellitus

Frontiers in Endocrinology ◽

10.3389/fendo.2021.788107 ◽

2021 ◽

Vol 12 ◽

Author(s):

Sabaa Joad ◽

Elliot Ballato ◽

FNU Deepika ◽

Giulia Gregori ◽

Alcibiades Leonardo Fleires-Gutierrez ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Bone Turnover ◽

Nonlinear Regression ◽

Bone Turnover Markers ◽

Hemoglobin A1c ◽

Group Iv ◽

Turnover Markers

BackgroundEmerging data suggest that type 2 diabetes mellitus (T2D) is associated with an increased risk for fractures despite relatively normal or increased bone mineral density (BMD). Although the mechanism for bone fragility in T2D patients is multifactorial, whether glycemic control is important in generating this impairment in bone metabolism remains unclear. The purpose of our study is to identify a hemoglobin A1c (A1c) threshold level by which reduction in bone turnover begins in men with T2D.MethodA cross-sectional analysis of baseline data was obtained from 217 men, ages 35–65, regardless of the presence or absence of hypogonadism or T2D, who participated in 2 clinical trials. The following data were obtained: A1c by HPLC, testosterone and estradiol by LC/MS, bone turnover markers Osteocalcin [OC], C-terminal telopeptide [CTx], and sclerostin by ELISA, and BMD by DXA. Patients were grouped into 4 categories based of A1c (group I: <6%, group II: 6.0–6.4%, group III: 6.5–6.9%, and group IV: ≥7%). Threshold models were fit to the data using nonlinear regression and group comparisons among the different A1c categories performed by ANOVA.ResultsThreshold model and nonlinear regression showed an A1c cut-off of 7.0, among all choices of A1cs, yields the least sum of squared errors. A comparison of bone turnover markers revealed relatively lower OC (p = 0.002) and CTx (p = 0.0002) in group IV (A1c ≥7%), compared to the other groups. An analysis of men with T2D (n = 94) showed relatively lower OC (p=0.001) and CTx (p=0.002) in those with A1c ≥7% compared to those with <7%, respectively. The significance between groups persisted even after adjusting for medications and duration of diabetes.ConclusionAn analysis across our entire study population showed a breakpoint A1c level of 7% or greater is associated with lower bone turnover. Also in men with T2D, an A1c ≥7% is associated with low bone turnover.

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Association between serum levels of bone turnover markers and bone mineral density in men and women with type 2 diabetes mellitus

Journal of Clinical Laboratory Analysis ◽

10.1002/jcla.23112 ◽

2019 ◽

Vol 34 (4) ◽

Author(s):

Chenhe Zhao ◽

Guangwang Liu ◽

Yao Zhang ◽

Guiping Xu ◽

Xilu Yi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Bone Mineral Density ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Bone Turnover ◽

Serum Levels ◽

Mineral Density ◽

Men And Women ◽

Turnover Markers

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Evaluation of biochemical bone turnover markers in postmenopausal patients with type 2 diabetes mellitus

Bone ◽

10.1016/j.bone.2008.07.208 ◽

2008 ◽

Vol 43 ◽

pp. S102

Author(s):

Xiuzhen Zhang ◽

Xiaochen Ding

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Bone Turnover ◽

Bone Turnover Markers ◽

Turnover Markers

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Bone Turnover Markers and Adipocytokinesresponse to Weight Reduction among Obese Patients with Type 2 Diabetes Mellitus

10.53902/sojdec.2021.01.000506 ◽

2021 ◽

Vol 1 (2) ◽

Author(s):

Shehab M Abd El Kader

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Bone Turnover ◽

Weight Reduction ◽

Control Group ◽

Obese Patients ◽

Mean Values ◽

Turnover Markers

Background: Type 2 diabetes mellitus (T2DM) is a highly prevalent disease associated with increased the risk of fracture due to altered bone micro architecture and/or poor quality as key factors. Bone remodeling appears to be impaired among patients with T2DM as both markers of bone formation and markers of bone resorption are decreased when compared to healthy subjects. Objective: This study aimed to detect if weight reduction modulates adipokines and markers of bone turnover among T2DM patients. Material and Methods: Eighty obese patients with T2DM (46 men and 34 women), their age ranged from 40-53 years and their body mass index ranged from 30-36 kg/m2 were equally assigned into 2 groups: the weight reduction group received aerobic exercises, diet regimen, where the control group received medical treatment only for 6 months. Results: The mean values of body mass index (BMI), leptin, resistin, visfatin levels significantly decreased, however the mean values of adiponectin, bone alkaline phosphatase (BAP) and serum cross-linked N-telopeptides of type I collagen (NTX) levels significantly increased in the training group. While, the results of the control group were not significant. In addition, there were significant differences between both groups at the end of the study. Conclusion: Weight loss ameliorates adipocytokines and bone turnover markers among obese patients with type 2 diabetes mellitus.

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Serum levels of vasohibin-1 in type 2 diabetes mellitus patients with diabetic retinopathy

European Journal of Ophthalmology ◽

10.1177/11206721211073403 ◽

2022 ◽

pp. 112067212110734

Author(s):

Ying Feng ◽

Da Wang ◽

Yan Liu ◽

Xiangzhong Pang ◽

Huijuan Zhang

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Logistic Regression ◽

Diabetic Retinopathy ◽

Multivariate Logistic Regression Analysis ◽

Serum Levels ◽

Enzyme Linked Immunosorbent Assay ◽

Increased Risk

Clinical relevance To determine whether Vasohibin-1 which is a potential clinical biomarker is an independent risk factor in patients with diabetic retinopathy. Background Diabetic retinopathy (DR) is a common chronic microangiopathy in type 2 diabetes mellitus (T2DM). Vasohibin-1 (VASH-1) is an angiogenesis regulator that is closely related to pathological vascularization in DM. This study aimed to determine whether the serum levels of VASH-1 were related to the occurrence of DR in T2DM patients. Methods T2DM patients were divided into three groups: the nondiabetic retinopathy (NDR) group (n = 41), the nonproliferative diabetic retinopathy (NPRD) group (n = 40), and the proliferative diabetic retinopathy (PDR) group (n = 41). A control (CON) group consisting of 40 healthy subjects was also recruited. The serum levels of VASH-1 were measured by enzyme-linked immunosorbent assay kits. Results The concentration of VASH-1 in the CON groups was less significantly than that of the NDR, NPDR and PDR groups. ( P < 0.05). Body mass index, fasting plasma glucose (FPG), hemoglobina1c (HbA1C), blood urea nitrogen (BUN) and diabetic durations were positively correlated with the serum concentration of VASH-1 (all P < 0.05). In univariate logistic regression analyses, the HbA1C, diabetic durations, HDL-c, eGFR and VASH1 were associated with the presence of diabetic retinopathy. Multivariate logistic regression analysis showed that duration of diabetes were significantly associated with diabetic retinopathy. Conclusion We have shown that VASH-1 is associated with an increased risk of developing diabetic retinopathy. But the serum levels of VASH-1 are not independent risk factors for DR in T2DM.

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