scholarly journals BONE REMODELING IN WOMEN WITH DIABETES MELLITUS

2018 ◽  
Vol 2 (5) ◽  
pp. 33-36
Author(s):  
Татьяна Бардымова ◽  
Tatyana Bardymova ◽  
Максим Мистяков ◽  
Maksim Mistyakov ◽  
Юлия Башарина ◽  
...  

Background. It is known that the type 2 diabetes mellitus (DM) and osteoporosis are more often diagnosed in senior women. The condition of a bone tissue is accompanied by the metabolic violations that are typical for DM. The recent researches established the multidirectional changes of bone remodeling markers in women with type 2 DM at differ- ent age periods. Aims: to study the condition of bone remodeling in women with type 2 DM at different age periods. Materials and methods. We examined 27 women with type 2 DM, among them 15 were in the post-menopausal period and 12 with preserved menstrual function. Levels of osteocalcin, N-terminal propeptide of type 1 collagen (P1NP), C- terminal telopeptide of type 1 collagen (β-Crosslaps), 25-OH vitamin D, the ionized calcium were researched. Results. The analysis showed that increase in β-Crosslaps levels, P1NP, levels of osteocaltcin were observed in women with type 2 DM in the post-menopausal period, compared to parameters of women with type 2 DM with preserved menstrual function. Inverse correlation relation of osteocaltcin and 25-OH vitamin D was revealed in women with type 2 DM. Conclusion. Significant increase in markers of osteosynthesis and osteoresorption in women with type 2 DM was shown in the post-menopausal period compared with indicators of women with type 2 DM with preserved men- strual function.

2021 ◽  
Vol 17 (1) ◽  
pp. 20-25
Author(s):  
O.A. Goncharova

Background. The urgency of the problem of comorbi­dity in diabetes mellitus (DM) is due to the observed aging of the population and a significant increase in the prevalence of DM, especially in the older age group, as well as the fact that DM itself is a comorbid pathology. The purpose of the study was to establish the frequency and structure of comorbid states in patients with type 1 DM and type 2 DM when using the team monitoring system, to investigate the provision of patients with vitamin D, and also to analyze, according to published meta-analyzes, the potential ability of vitamin D to positively influence the frequent comorbid patho­logy in patients with DM. Materials and methods. In 42 women with DM (15 with type 1 DM and 27 with type 2 DM), the frequency and structure of comorbidity, established in the context of the team strategy of patient management, were analyzed. The blood level of 25(OH)D was determined by the enzyme immunoassay using an immunoassay on Modular Analytics E170 analyzer. Results. In the considered groups, the average age of women was significantly higher in the group of type 2 DM compared with type 1 DM (56.67 ± 3.03 versus 33.8 ± 2.59 years, p < 0.01). At the same time, 12 comorbid pathologies of the 15 pathological conditions consi­dered were detected in type 1 DM, and in type 2 DM — all 15. With type 1 DM, neuropathy (100 % versus 77.8 %, p < 0.05), retinopathy (100 % versus 55.6 %, p < 0.01) were significantly more frequently detected, and type 2 DM was associated with hypertension (77.8 % versus 20.0 %, p < 0.001), obesity (55.62 % versus 0 %), and liver pathology (33.8 % versus 0 %). In both groups, there was a high incidence of cardiopathy (100 % in type 1 DM versus 88.9 % in type 2 DM), encephalopathy (80 % versus 88.9 %), thyroid patho­logy (60 % versus 77.8 %). The average number of comorbid states significantly prevailed in type 2 DM (8.56 ± 2.19 versus 7.0 ± 0.9, p < 0.05). The blood level of vitamin D was reduced in both types of DM, while in women with type 2 DM, it corresponded to deficiency, and in type 1 DM — with its lack (19.55 ± 1.8 ng/ml versus 28.98 ± 1.2 ng/ml, p < 0.001). Conclusions. The use of a team exa­mination strategy made it possible to establish that in women with type 1 DM and type 2 DM, there is a rejuvenation of age qualifications, a significant increase in the number of comorbid pathologies. In type 2 DM, the rate of increase in the number of comorbid states is higher than in type 1 DM. Even with a significantly shorter duration of DM, the number of comorbid states is significantly higher in them. Type 1 DM in women is accompanied by vitamin D lack, and type 2 DM is accompanied by vitamin D deficiency. At the same time, today there is no final understanding of whether a lack of vitamin D is a risk factor for DM or DM is accompanied by a decrease in the level of vitamin D. Understanding this issue will determine the optimal timing of the prophylactic administration of vitamin D.


Author(s):  
Maria Diah Pramudianti ◽  
Briggite Rina Aninda Sidharta ◽  
Josua Sinambela ◽  
Medityas Winda Krissinta

Diabetes Mellitus (DM) is a metabolic disease characterized by hyperglycemia due to abnormal secretions and/or insulin activity. Osteopontin (OPN) is an important component of inflammation and insulin resistance, and vitamin D decreases insulin resistance. This study aimed to analyze the correlation between OPN and glycemic control and total 25-OH vitamin D in type 2 DM. An observational analytic study with a cross-sectional approach was performed in Dr. Moewardi Hospital, Surakarta, from May to September 2018. Plasma OPN levels were measured by a sandwich enzyme immunoassay kit from Elabscience 96T Human OPN (USA), and a total of 25-OH vitamin D was evaluated using the ELFA method from Biomerieux SA (France). Data were tested by Pearson correlation (r). Type 2 DM subjects consisted of 45 (54.2%) males and 38 (45.8%) females, 36 (43.45%) well- and 47 (56.65%) poorly-controlled. The average age was 56.81±9.76 years old. The mean of OPN level in poorly-controlled cases was significantly higher (20.27±3.20 ng/mL) than well-controlled ones (15.04±3.34 ng/mL) with p=0.001. There was no significant difference in total 25-OH vitamin D between well- and poorly-controlled groups (19.84±6.65 vs. 17.24±6.78 ng/mL, respectively, p=0.085). The correlation of OPN with glycemic control (fasting glucose, 2-hour post-prandial glucose, HbA1c) and total 25-OH vitamin D in all subjects with type 2 DM were r=0.241 (p=0.028), r=0.378 (p=0.0001) r=0.529 (p=0.0001) and r=-0.151 (p=0.173), respectively. This study suggested that plasma OPN level was correlated with glycemic control but not with serum total 25-OH vitamin D in type 2 DM. Further research was needed in populations of other types of DM and other research variables related to inflammation or insulin resistance.


1970 ◽  
Vol 19 (4) ◽  
pp. 2812-2818
Author(s):  
Ayman S Al-Hazmi

Background: Type 2 diabetes mellitus (T2DM) is a global problem. Association of multiple genes in T2DM becomes a hot point recently. This study was aimed to evaluate association of vitamin D receptor gene polymorphisms with susceptibility to T2DM. Subjects and methods: One hundred T2DM Saudi male patients were included in this study and one hundred healthy Saudi men were used as control. For each individual, fasting blood glucose, cholesterol, HDL-C, LDL-C, HbA1c, insulin and 25-(OH) vitamin D were measured. In addition, Apal, BsmI and TaqI genotypes were performed for each subject. Data was analyzed by SPSS version 16, using Spearman's rho and ANOVA tests. Results: There was significant inverse correlation between 25-(OH) vitamin D level and T2DM (p<0.01). HbA1c was inversely correlated with 25-(OH) vitamin D level (P<0.05). Genotype study showed that tt of TaqI genotype was higher in T2DM group compared with control group (p<0.05). Moreover, tt genotype has higher HbA1c than both TT and Tt genotypes (p<0.05). Conclusion: An association was confirmed between TaqI genotypes and T2DM but there is no correlation between BsmI, ApaI and T2DM. In addition, HbA1c is positively correlated with tt genotype of TaqI.Keywords: Vitamin D receptor, diabetes type 2, polymorphism.


2005 ◽  
Vol 11 (3) ◽  
pp. 177-180 ◽  
Author(s):  
L. A. Lohankova ◽  
Yu. V. Kotovskaya ◽  
A. S. Milto ◽  
Zh. D. Kobalava

The structural and functional features of the microcirculatory heel (MCB) were studied in patients with arterial hypertension (AH) in relation to the presence or absence of type 1 diabetes mellitus (DM). Two hundred and twelve patients were examined. These included 110 patients with grades 1 and 2 arterial hypertension (AH) and type 2 DM, 82 patients with AH without type 2 DM, and 20 apparently healthy individuals. Laser Doppler flowmetry (LDF) was used to estimate basal blood flow, the loading test parameters characterizing the structural and functional status of MCB, and the incidence of hemodynamic types of microcirculation. Patients with AH concurrent with type 1 DM were found to have the following microcirculatory features: an increase in perfusion blood flow (microcirculation index, 8,8±1,8 perf. units versus 4,9±0,8 perf, units in patients with AH without DM and 6,7±0,9 perf. units in the control group), a drastic reduction in myogenic activity to 13,2±5,7 % versus 16,7±6,8 and 25,2±6,4 %, respectively, a decrease in vascular resistance, impairment of autoregulation, and low reserve capacities (reserve capillary blood flow was 197,8±31,6 % versus 429,9±82,01 % in the group of AH without DM and 302,8±50,1 % in the control group), a predominance of the hyperemic hemodynamic type (58,8 % in patients with AH and DM, 20,9 % in those with AH without DM, and 20,0 % in the controls). The specific features of the altered microcirculatory bed in patients with AH concurrent with type 2 DM were ascertained. These included the predominance of hyperemic microcirculation, impaired autoregulation. diminished microvascular resistance, and the low reserve capacities of the microcirculatory bed.


2020 ◽  
Vol 77 (6) ◽  
pp. 582-589
Author(s):  
Marijana Petrovic ◽  
Tamara Dragovic ◽  
Stanko Petrovic ◽  
Katarina Obrencevic ◽  
Nemanja Rancic ◽  
...  

Background/Aim. Vitamin D insufficiency/deficiency is often present in patients with type-2 diabetes mellitus (DM) and could present a risk factor for rapid progression of diabetic nephropathy and for higher incidence of cardiovascular events. The aim of this study was to examine the influence of vitamin D supplementation on proteinuria, cholesterol, triglycerides, C-reactive protein (CRP) and hemoglobin A1c in patients with type-2 DM and vitamin D insufficiency/ deficiency. Methods. This prospective, cohort study included 90 patients with type-2 DM and vitamin D insufficiency/ deficiency divided into 3 equal groups: with normal proteinura, with microproteinuria and with macroproteinuria. Therapy included six months of supplementation with cholecalciferol drops: first two months with 20,000 IU twice weekly, than if level of vitamin D was below normal the same dose was given next four months. If the level of vitamin D was normal 5,000 IU was given twice weekly. At the begining and at the end of the study the levels of urea, creatinine, fasting blood glucose, calcium, phosphorus, cholesterol, triglycerides, CRP, hemoglobin A1c, intact parathyroid hormone, 24-hour urine protein and creatinine clearance were determined. Levels of calcium, phosphorus and vitamin D were also checked 2 months after beginning of therapy due to possible correction of cholecalciferol dose. Results. The lowest level of vitamin D before therapy was found in patients with macroproteinuria, while at the end of the study the significantly higher level of vitamin D was found in all three groups. After 6 months of therapy a significant decrease of 24-hour urine protein, cholesterol, triglycerides, hemoglobin A1c in all three groups, and CRP in patients with normal proteinuria and microproteinuria were found. Significantly negative correlation between vitamin D and 24-hour urine protein, cholesterol and CRP was found in patients with macroproteinuria. Also, significantly negative correlation was found between vitamin D and hemoglobin A1c, in patients with normal proteinuria, vitamin D and CRP in patients with microproteinuria. Conclusion. A preventive use of high-dose cholecalciferol supplementation in patients with type-2 DM (with or without proteinuria) decreases cholesterol, triglycerides, proteinuria, CRP and hemoglobin A1c.


Author(s):  
Jui-Yang Wang ◽  
Hsin-Chung Lin ◽  
Hsin-An Lin ◽  
Chi-Hsiang Chung ◽  
Lih-Chyang Chen ◽  
...  

Patients with diabetes mellitus (DM) are at greater risk of developing active tuberculosis and other intracellular bacterial infections, although the risk of acquiring infections from nontuberculous Mycobacterium (NTM) remains undefined. This study evaluated associations between DM and incidence of NTM infection-caused pulmonary and cutaneous diseases. Data for DM patients were extracted from the National Health Insurance Research Database of Taiwan. The DM cohort included 136,736 patients, and cases were matched randomly by age, gender, and index year with non-DM patients. Multivariate Cox proportional hazards regression was used to calculate adjusted hazard ratios of incident NTM-caused diseases in the DM cohort compared with non-DM control subjects. The frequency of incident NTM-caused diseases was significantly greater in DM patients (0.12%) than in non-DM patients (0.08%) (P < 0.05), including patients with type 1 DM (0.12%) and type 2 DM (0.12%) (all P < 0.05). Adjusted multivariate Cox regression analysis revealed that the incidence of NTM-caused diseases in DM patients was 1.43-fold greater than that in non-DM patients overall (P < 0.05), particularly in pulmonary (1.13-fold), other specific (excluding pulmonary, cutaneous, and disseminated diseases; 3.88-fold), and unspecific (atypical NTM infection; 1.54-fold) diseases (all P < 0.05). In conclusion, both type 1 DM and type 2 DM patients have high risk of NTM-caused diseases, suggesting that physicians need to pay more attention to this issue concerning the high risk of NTM-caused infection in DM patients.


2017 ◽  
Vol 6 (8) ◽  
pp. 758-765 ◽  
Author(s):  
Borros Arneth

Background The origin of autoimmune disease type 1 diabetes is still unknown. Aim This study assessed the activation of CD4+ and CD8+ T-lymphocytes by human insulin and human glutamate decarboxylase (GAD) in patients with type 1 or type 2 diabetes mellitus (DM) and healthy volunteers. Materials and methods The expression of CD69, a marker of T-lymphocyte activity, was determined in whole blood samples by flow cytometry after 12 h of incubation with or without insulin or GAD. The analysis included samples from 12 type 1 DM patients, 14 type 2 DM patients and 12 healthy volunteers. Results Significant increases in the number of activated CD4+ and CD8+ T-lymphocytes following pre-incubation of whole blood samples with human insulin or GAD were observed in samples from patients with type 1 DM, whereas no activation of these cells was detected in samples from either type 2 DM patients or healthy subjects. Discussion These results indicated that latent pre-activation of CD4+ and CD8+ T-lymphocytes in response to insulin or GAD epitopes occurred in type 1 DM patients. Conclusion These findings suggest that pre-immunization against insulin and/or GAD might be associated with the development of type 1 DM. Alternatively, these results might reflect a non-specific, bystander autoimmune response.


Molecules ◽  
2020 ◽  
Vol 25 (19) ◽  
pp. 4381
Author(s):  
Zakiyatul Faizah ◽  
Bella Amanda ◽  
Faisal Yusuf Ashari ◽  
Efta Triastuti ◽  
Rebecca Oxtoby ◽  
...  

Diabetes mellitus (DM) is one of the major causes of death in the world. There are two types of DM—type 1 DM and type 2 DM. Type 1 DM can only be treated by insulin injection whereas type 2 DM is commonly treated using anti-hyperglycemic agents. Despite its effectiveness in controlling blood glucose level, this therapeutic approach is not able to reduce the decline in the number of functional pancreatic β cells. MST1 is a strong pro-apoptotic kinase that is expressed in pancreatic β cells. It induces β cell death and impairs insulin secretion. Recently, a potent and specific inhibitor for MST1, called XMU-MP-1, was identified and characterized. We hypothesized that treatment with XMU-MP-1 would produce beneficial effects by improving the survival and function of the pancreatic β cells. We used INS-1 cells and STZ-induced diabetic mice as in vitro and in vivo models to test the effect of XMU-MP-1 treatment. We found that XMU-MP-1 inhibited MST1/2 activity in INS-1 cells. Moreover, treatment with XMU-MP-1 produced a beneficial effect in improving glucose tolerance in the STZ-induced diabetic mouse model. Histological analysis indicated that XMU-MP-1 increased the number of pancreatic β cells and enhanced Langerhans islet area in the severe diabetic mice. Overall, this study showed that MST1 could become a promising therapeutic target for diabetes mellitus.


2020 ◽  
Vol 58 (3) ◽  
pp. 290-293
Author(s):  
S. S. Safarova ◽  
S. S. Safarova

Diabetic osteopathy is one of the little studied complications of diabetes mellitus (DM), which leads to common lowtrauma fractures and, as a consequence, disability and death. The level of insulin is connected with bone functional and morphological changes followed by decreased bone mineral density (BMD) in the early stages of diabetic osteopathy. Objective: to study bone morphofunctional properties in males with type 1 and 2 DM (T1DM and T2DM). Subjects and methods. Examinations were made in 41 male patients with T1DM and 52 male patients with T2DM without a history of fractures. Their age varied from 40 to 70 years (mean age, 55.8±0.7 years and 58.4±0.9 years, respectively). A control group consisted of 34 patients (mean age, 55.9±0.9 years) without a history of DM. Patients with other endocrine disorders, end-stage complications, or chronic liver and kidney diseases were excluded from the investigation. BMD was determined by dual-energy X-ray absorptiometry (DXA). Serum bone remodeling markers (procollagen type 1 amino-terminal propeptide and C-terminal telopeptide), as well as 25(OH)D, parathyrin, insulin, glycated hemoglobin (HbA1c), and electrolytes (Ca2+, P+) were evaluated. Results and discussion. An association of BMD with renal function, HbA1c, and body mass index was observed in patients with T2DM. In the T1MD group, BMD was closely related to insulin deficiency and was significantly lower than that in the control group. In patients with vitamin D deficiency, BMD was significantly lower than in those with normal vitamin D levels (p<0.05). The patients with T1DM displayed both a decrease in BMD (p<0.05) and a pronounced change in the levels of bone markers (p<0.05). Those with T2DM had impaired bone remodeling processes, which was determined by the level of these markers (p<0.05) and observed in the presence of normal BMD due to the complex pathophysiology of the underlying disease. Conclusion. Vitamin D deficiency, insufficient and decreased insulin sensitivity, hyperglycemia, and overweight are important causes of osteopathy in patients with DM. The markers of bone remodeling may become promising indicators for diagnosing osteopathy, but additional studies are needed to elaborate recommendations for their use in routine practice in order to predict and prevent this complication of DM.


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