Bone turnover and metabolite responses to exercise in people with and without long-duration type 1 diabetes: a case–control study

IntroductionExercise acutely alters markers of bone resorption and formation. As risk of fracture is increased in patients with type 1 diabetes, understanding if exercise-induced bone turnover is affected within this population is prudent. We assessed bone turnover responses to acute exercise in individuals with long-duration type 1 diabetes and matched controls.Research design and methodsParticipants with type 1 diabetes (n=15; age: 38.7±13.3; glycosylated hemoglobin: 60.5±6.7 mmol/mol; diabetes duration: 19.3±11.4 years) and age-matched, fitness-matched, and body mass index-matched controls (n=15) completed 45 min of incline walking (60% peak oxygen uptake). Blood samples were collected at baseline and immediately, 30 min, and 60 min postexercise. Markers of bone resorption (β-C-terminal cross-linked telopeptide of type 1 collagen, β-CTx) and formation (procollagen type-1 amino-terminal propeptide, P1NP), parathyroid hormone (PTH), phosphate, and calcium (albumin-adjusted and ionized) were measured. Data (mean±SD) were analyzed by a mixed-model analysis of variance.ResultsBaseline concentrations of P1NP and β-CTx were comparable between participants with type 1 diabetes and controls. P1NP did not change with exercise (p=0.20) but β-CTx decreased (p<0.001) in both groups, but less so in participants with type 1 diabetes compared with controls (−9.2±3.7%; p=0.02). PTH and phosphate increased immediately postexercise in both groups; only PTH was raised at 30 min postexercise (p<0.001), with no between-group differences (p>0.39). Participants with type 1 diabetes had reduced albumin and ionized calcium at all sample points (p<0.01).ConclusionsFollowing exercise, participants with type 1 diabetes displayed similar time-course changes in markers of bone formation and associated metabolites, but an attenuated suppression in bone resorption. The reduced albumin and ionized calcium may have implications for future bone health. Further investigation of the interactions between type 1 diabetes, differing modalities and intensities of exercise, and bone health is warranted.

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Serum percentage undercarboxylated osteocalcin, a sensitive measure of vitamin K status, and its relationship to bone health indices in Danish girls

British Journal Of Nutrition ◽

10.1017/s0007114507433050 ◽

2007 ◽

Vol 97 (4) ◽

pp. 661-666 ◽

Cited By ~ 36

Author(s):

Eibhlis O'Connor ◽

Christian Mølgaard ◽

Kim F. Michaelsen ◽

Jette Jakobsen ◽

Christel J. E. Lamberg-Allardt ◽

...

Keyword(s):

Lumbar Spine ◽

Bone Resorption ◽

Bone Turnover ◽

Vitamin K ◽

Bone Health ◽

Undercarboxylated Osteocalcin ◽

Pubertal Stage ◽

Cross Sectional ◽

Total Body ◽

Markers Of Bone Resorption

Recent cross-sectional data suggest that better vitamin K status in young girls (aged 3–16 years) is associated with decreased bone turnover, even though it is not associated with bone mineral content (BMC). The objective of the present study was to investigate the relationship between serum percentage of undercarboxylated osteocalcin (%ucOC), as an index of vitamin K status, and BMC and biochemical indices of bone turnover in peri-pubertal Danish girls. This peri-pubertal stage is a dynamic period of bone development, and as such, may represent an important window of opportunity for vitamin K status to modulate childhood bone health. Serum %ucOC and serum 25-hydroxyvitamin D (25 (OH) D) were measured at baseline in a study of 223 healthy girls aged 11–12 years. Urinary pyridinium crosslinks of collagen and serum total osteocalcin as markers of bone resorption and formation, respectively, as well as BMC (total body and lumbar spine) were also measured. Serum %ucOC (median 21·9 %) was not associated with markers of bone resorption or with total osteocalcin. Serum %ucOC was inversely correlated with serum 25 (OH) D (r− 0·143;P < 0·05). Serum %ucOC was negatively associated with BMC of the total body (β − 0·045;P < 0·001) and lumbar spine (β − 0·055;P < 0·05), after adjustment for potential confounders including vitamin D status. Better vitamin K status was associated with increased BMC, but not bone turnover, in healthy peri-pubertal Danish girls. There is a need for well-designed, randomized phylloquinone supplementation trials in children and adolescents to confirm epidemiological findings of an association between vitamin K status and bone health.

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Altered cortical bone strength and lean mass in young women with long-duration (19 years) type 1 diabetes

Scientific Reports ◽

10.1038/s41598-020-78853-7 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Daniel Novak ◽

Gun Forsander ◽

Eva Kristiansen ◽

Anna Svedlund ◽

Per Magnusson ◽

...

Keyword(s):

Type 1 Diabetes ◽

Body Composition ◽

Cortical Bone ◽

Bone Strength ◽

Young Women ◽

Lean Mass ◽

Bone Health ◽

Diabetes Duration ◽

Long Duration

AbstractTo investigate bone health and body composition in young women with long-duration type 1 diabetes (T1D) in relation to matched controls. Twenty-three Swedish women, age 19.2–27.9 years, with a T1D duration of 10 years or more were recruited from the Swedish National Diabetes Registry (NDR). An age-, gender- and geography-matched control group was recruited. Bone mass and body composition were assessed by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography. Data was retrieved from the NDR and SWEDIABKIDS registries. T1D individuals had a mean diabetes duration of 19 years. T1D individuals had reduced lean mass (40.0 ± 6.1 kg vs. 43.9 ± 4.9 kg) and were shorter (1.66 ± 0.06 m vs. 1.71 ± 0.06 m) although comparable BMI. Subjects with T1D had lower muscle area (P = 0.0045). No differences were observed for fractures; physical activity; total, lumbar spine or femur areal bone mineral density. The cortical bone strength strain index was lower for TD1 patients (1875 ± 399 mm3 vs. 2277 ± 332 mm3). In conclusion, young women with long-term diabetes duration showed reduced cortical bone strength, decreased periosteal circumference, endosteal circumference and altered body composition. These factors contribute to the health burden of TD1, which warrants further attention for advancing bone health in women with T1D.

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Bone Health Index and bone turnover in pediatric patients with type 1 diabetes mellitus and poor metabolic control

Pediatric Diabetes ◽

10.1111/pedi.12930 ◽

2019 ◽

Vol 21 (1) ◽

pp. 88-97

Author(s):

Olga Slavcheva‐Prodanova ◽

Maia Konstantinova ◽

Adelina Tsakova ◽

Radka Savova ◽

Margarita Archinkova

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Bone Turnover ◽

Type 1 Diabetes Mellitus ◽

Metabolic Control ◽

Bone Health ◽

Pediatric Patients ◽

Health Index ◽

Bone Health Index

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Review for "Acute hyperinsulinemia alters bone turnover in women and men with type 1 diabetes"

10.1002/jbm4.10389/v1/review2 ◽

2020 ◽

Keyword(s):

Type 1 Diabetes ◽

Bone Turnover

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Insulin doses requirements in patients with type 1 diabetes using glargine U300 or degludec in routine clinical practice

Journal of Investigative Medicine ◽

10.1136/jim-2020-001633 ◽

2021 ◽

pp. jim-2020-001633

Author(s):

Florentino Carral San Laureano ◽

Mariana Tomé Fernández-Ladreda ◽

Ana Isabel Jiménez Millán ◽

Concepción García Calzado ◽

María del Carmen Ayala Ortega

Keyword(s):

Type 1 Diabetes ◽

Clinical Practice ◽

Retrospective Study ◽

Real World ◽

Glycosylated Hemoglobin ◽

Routine Clinical Practice ◽

Insulin Analogs ◽

Total P ◽

Real Clinical Practice

There are not many real-world studies evaluating daily insulin doses requirements (DIDR) in patients with type 1 diabetes (T1D) using second-generation basal insulin analogs, and such comparison is necessary. The aim of this study was to compare DIDR in individuals with T1D using glargine 300 UI/mL (IGlar-300) or degludec (IDeg) in real clinical practice. An observational, retrospective study was designed in 412 patients with T1D (males: 52%; median age 37.0±13.4 years, diabetes duration: 18.7±12.3 years) using IDeg and IGla-300 ≥6 months to compare DIDR between groups. Patients using IGla-300 (n=187) were more frequently males (59% vs 45.8%; p=0.004) and had lower glycosylated hemoglobin (HbA1c) (7.6±1.2 vs 8.1%±1.5%; p<0.001) than patients using IDeg (n=225). Total (0.77±0.36 unit/kg/day), basal (0.43±0.20 unit/kg/day) and prandial (0.33±0.23 unit/kg/day) DIDR were similar in IGla-300 and IDeg groups. Patients with HbA1c ≤7% (n=113) used significantly lower basal (p=0.045) and total (p=0.024) DIDR, but not prandial insulin (p=0.241), than patients with HbA1c between 7.1% and 8% and >8%. Patients using IGla-300 and IDeg used similar basal, prandial and total DIDR regardless of metabolic control subgroup. No difference in basal, prandial and total DIDR was observed between patients with T1D using IGla-300 or IDeg during at least 6 months in routine clinical practice.

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The changes in bone turnover markers of female systemic lupus erythematousus patients without glucocorticoid

Lupus ◽

10.1177/09612033211000126 ◽

2021 ◽

Vol 30 (6) ◽

pp. 965-971

Author(s):

Wang Tianle ◽

Zhang Yingying ◽

Hong Baojian ◽

Gu Juanfang ◽

Wang Hongzhi ◽

...

Keyword(s):

Bone Resorption ◽

Bone Formation ◽

Bone Turnover ◽

Bone Metabolism ◽

Bone Turnover Markers ◽

Control Group ◽

Bone Resorption Marker ◽

Amino Terminal ◽

Normal People ◽

Turnover Markers

Objectives SLE is a chronic autoimmune disease, which can affect the level of bone metabolism and increase the risk of osteoporosis and fracture. The purpose of this research is to study the effect of SLE on bone turnover markers without the influence of glucocorticoids. Methods A total of 865 female subjects were recruited from Zhejiang Provincial People’s Hospital and the First Hospital of Jiaxing, including 391 SLE patients without the influence of glucocorticoids and 474 non-SLE people. We detected Bone turnover markers including amino-terminal propeptide of type 1 procollagen (P1NP), C-terminal turnover of β - I collagen (β-CTX), N-terminal midfragment of osteocalcin (NMID) and 25(OH)D, and analyzed the difference in Bone turnover markers between the SLE group and the control group, as well as the influence of age and season on bone metabolism in female SLE patients. Results In the SLE group, the average age was 43.93±13.95 years old. In the control group, the average age was 44.84±11.42 years old. There was no difference between the two groups (t = 1.03, P = 0.30). P1NP, NMID and 25(OH)D in the SLE group were significantly lower than those in the control group (Z = 8.44, p < 0.001; Z = 14.41, p < 0.001; Z = 2.19, p = 0.029), and β-CTX in the SLE group was significantly higher than that in the control group (Z = 2.61, p = 0.009). In addition, the levers of β-CTX, NMID, P1NP and 25(OH)D in older SLE female patients were statistically significantly higher than those in younger (ρ = 0.104, p = 0.041; ρ = 0.223, p < 0.001; ρ = 0.105, p = 0.038; ρ = 0.289, p < 0.001). Moreover, β-CTX reached a high value in summer and PINP reached a low value in winter. Conclusion The bone formation markers of female SLE patients without glucocorticoid were lower than those of normal people and the bone resorption marker was higher than that of normal people. The 25 (OH) D of female SLE patients without glucocorticoid was lower than that of normal people. The risk of osteoporosis and fracture may be higher in elderly women with SLE. The bone resorption level of female SLE patients is high in summer and the bone formation level is low in winter.

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