Can fingernail quality predict bone damage in Type 2 diabetes mellitus? a pilot study

Type 2 diabetes mellitus (T2DM) adversely affects the normal functioning, intrinsic material properties, and structural integrity of many tissues, including bone. It is well known that the clinical utility of areal bone mineral density (aBMD) is limited to assess bone strength in individuals with T2DM. Therefore, there is a need to explore new diagnostic techniques that can better assist and improve the accuracy of assessment of bone tissue quality. The present study investigated the link between bone and fingernail material/compositional properties in type 2 diabetes mellitus (T2DM). For that, femoral head and fingernail samples were obtained from twenty-five adult female patients (with/without T2DM) with fragility femoral neck fractures undergoing hemi/total hip arthroplasty. Cylindrical cores of trabecular bone were subjected to micro-CT, and lower bone volume fraction was observed in the diabetic group than the non-diabetic group due to fewer and thinner trabeculae in individuals with T2DM. The material and compositional properties of bone/fingernail were estimated using nanoindentation and Fourier Transform Infrared Spectroscopy, respectively. Both bone/fingernails in T2DM had lower reduced modulus (Er), hardness (H), lower Amide I and Amide II area ratio (protein content), higher sugar-to-matrix ratio, and relatively high carboxymethyl-lysine (CML) content compared with non-diabetic patients. Sugar-to-matrix ratio and relative CML content were strongly and positively correlated with HbA1c for both bone/fingernail. There was a positive correlation between bone and fingernail glycation content. Our findings provide evidence that the degradation pattern of bone and fingernail properties go hand-in-hand in individuals with T2DM. Hence, the fingernail compositional/material properties might serve as a non-invasive surrogate marker of bone quality in T2DM; however, further large-scale studies need to be undertaken.

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Update on the impact of type 2 diabetes mellitus on bone metabolism and material properties

Endocrine Connections ◽

10.1530/ec-18-0456 ◽

2019 ◽

Vol 8 (3) ◽

pp. R55-R70 ◽

Cited By ~ 10

Author(s):

Ann-Kristin Picke ◽

Graeme Campbell ◽

Nicola Napoli ◽

Lorenz C Hofbauer ◽

Martina Rauner

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Material Properties ◽

Bone Fragility ◽

Diabetic Patients ◽

Mineral Density ◽

Increased Risk ◽

The Impact

The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide, especially as a result of our aging society, high caloric intake and sedentary lifestyle. Besides the well-known complications of T2DM on the cardiovascular system, the eyes, kidneys and nerves, bone strength is also impaired in diabetic patients. Patients with T2DM have a 40–70% increased risk for fractures, despite having a normal to increased bone mineral density, suggesting that other factors besides bone quantity must account for increased bone fragility. This review summarizes the current knowledge on the complex effects of T2DM on bone including effects on bone cells, bone material properties and other endocrine systems that subsequently affect bone, discusses the effects of T2DM medications on bone and concludes with a model identifying factors that may contribute to poor bone quality and increased bone fragility in T2DM.

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Osteocalcin: the relationship between bone metabolism and glucose homeostasis in diabetes mellitus

INTERNATIONAL JOURNAL OF ENDOCRINOLOGY ◽

10.22141/2224-0721.17.4.2021.237347 ◽

2021 ◽

Vol 17 (4) ◽

pp. 322-328

Author(s):

A.V. Кovalchuk ◽

О.В. Zinych ◽

V.V. Korpachev ◽

N.M. Кushnareva ◽

О.В. Prybyla ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Bone Metabolism ◽

The Body ◽

Diabetic Patients ◽

Inverse Association ◽

Mineral Density ◽

Peripheral Tissues

Recent studies have demonstrated the importance of bone as an endocrine organ that produces biologically active substances, which regulate both local bone metabolism and metabolic functions throughout the body. In the process of bone remodeling (formation/destruction), the active cells secrete specific biomarkers that help detect osteometabolic dysfunction. Among bone hormones, osteocalcin plays an important role as a coordinator of bone modeling processes, energy homeostasis, metabolism of glucose, lipids and minerals. Osteocalcin is a structural protein of the bone matrix, which is synthesized by osteoblasts and enters the bloodstream in the process of bone resorption. The level of osteocalcin in the serum is used as a specific marker of bone formation. Osteocalcin promotes pancreatic β-cell proliferation and insulin secretion, and also affects the insulin sensitivity of peripheral tissues. The inverse association of glycemia with the level of osteocalcin was revealed. Patients with type 2 diabetes mellitus usually have normal or even slightly elevated bone mineral density compared to age-appropriate controls. Decreased bone quality and increased risk of fractures are associated with changes in bone microarchitecture and local humoral environment. An imbalance in osteoblast/osteoclast activity may be due to oxidative stress and the accumulation of glycosylation end products, which contributes to chronic inflammation and bone resorbtion in patients with diabetes. It is shown that the level of osteocalcin in the blood serum is significantly reduced compared to healthy controls, both in patients with type 1 diabetes mellitus and, especially, in type 2 diabetes mellitus. Given the importance of developing new approaches to the diagnosis and correction of metabolic disorders in diabetic patients, the study of the influence of bone hormones on hormonal and metabolic parameters and bone status, including the risk of fractures, remains relevant in modern diabetology.

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The association between Gastric Bacterial Infection and Low Level of Vitamin D among Patients with type 2 Diabetes Mellitus

Baghdad Journal of Biochemistry and Applied Biological Sciences ◽

10.47419/bjbabs.v2i01.32 ◽

2021 ◽

Vol 2 (01) ◽

pp. 38-46

Author(s):

Sarah T. Al-Mofarji ◽

Haider .K. Hussien ◽

Nadira Salman Mohamed ◽

Sundus Fadhil Hantoosh ◽

Mohammed Khudier Abass ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Vitamin D ◽

Type 2 Diabetes Mellitus ◽

Fasting Blood Glucose ◽

Diabetic Group ◽

Diabetic Patients ◽

Vitamin D Levels ◽

H Pylori

Objectives: The present research aimed to find an association between infection by Helicobacter pylori and vitamin D deficiency in type 2 diabetes mellitus among Iraqi individuals attending Al-Yarmouk Teaching Hospital. Methods: According to fasting blood glucose, the samples were divided into a non-diabetic group with ten diabetic individuals and a diabetic group with thirty individuals. Results: The anti-H. Pylori (IgG) levels were 86.77± 58.62 NTU/µL in diabetic patients compared with 10.12 ± 7.40 NTU/µL in non- diabetic group. Vitamin D levels were decreased significantly in infected patients compared to non-infected subjects. Conclusion: The H pylori-infected patients have recorded the lowest level of vitamin D than non-infected individuals.

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“MEAN PLATELET VOLUME CORRELATED TO GLYCEMIC CONTROL IN TYPE 2 DIABETES MELLITUS”

10.36106/ijsr/6922290 ◽

2021 ◽

pp. 62-64

Author(s):

Rifat Qureishi ◽

S. K Sutrakar ◽

P C Kol ◽

UR Singh ◽

M H Usmani

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Mean Platelet Volume ◽

Vascular Complications ◽

Diabetic Group ◽

Macrovascular Complications ◽

Diabetic Patients ◽

Platelet Volume

Background: Diabetes mellitus (DM) is becoming a global pandemic. The number of people with diabetes in India increased from 26·0 million in 1990 to 65·0 million in 2016. Diabetes mellitus (DM) has been considered as a 'prothrombotic state' with enhanced platelet reactivity. Diabetic patients have an increased risk of developing micro and macro vascular diseases, and platelets may be involved as putative agents owing to their altered morphology, function and activation. It is an established fact that the value of glycated hemoglobin (HbA1c), a marker of long-term glucoregulation, should be kept below 7% in order to reduce the risk of micro and macrovascular complications in Type 2 Diabetes Mellitus (DMT2) patients. Mean platelet volume (MPV) has been correlated with vascular complications of DMT2. MPV as a marker of platelet size, function & activation may serve as another potential marker of risk of micro-vascular and macrovascular complications in DMT2 patients. Aims-To study correlation between MPV, and HbA1c in DMT2 patients. Methods- Over a period of 24 months, patients aged between 30 to 60 years, diagnosed with DMT2 and subtyped based on American Diabetic Association Criteria (ADA) as having HbA1c either less than 7% - DMT2 (Controlled group) or with HbA1c more than 7% - DMT2 (Uncontrolled group) were included in the present study. Non-diabetic patients ('Non Diabetic Group) were included based on their fasting and post prandial blood glucose levels and served as controls. Venous blood samples were tested for fasting, postprandial and random blood sugar estimation by GOD-POD method, MPV by automated cell counter and HbA1c by HPLC, within one hour of sampling. Results were statistically tested using (R) unpaired t Test by SPSS Software (version 22). Results- Among 236 patients studied, 66 were 'Non-diabetic controls' & 170 were having diabetes (DMT2). Of those having DMT2, 94 patients belonged to DMT2 (Uncontrolled group) 76 patients belonged to DMT2 (Controlled group). MPV in Non-diabetic group, DMT2 (Controlled group) and DMT2 (Uncontrolled group) was 10.01 ± 1.12 , 10.76 ± 1.11  and 11.67 ± 1.83  respectively. MPVwas signicantly higher in DMT2 group compared to Non-diabetic group (10.82 ± 1.31  vs 10.01 ± 1.12 , p < 0.0001), MPV was also signicantly higher in DMT2 (Uncontrolled group) compared to DMT2 (Controlled group) (11.67 ± 1.83  vs. 10.76 ± 1.11 , p < 0.0001). Conclusion- In the present study Mean Platelet Volume was found to be signicantly higher in Diabetes Mellitus Type 2 patient compared to Nondiabetic patients. Higher MPV also correlated with higher HbA1c, being higher in those with higher HbA1c. It can be concluded that MPV may be useful as inexpensive surrogate marker of HbA1c in the diagnosis and prognosis of vascular complications of DMT2 patients.

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A study of magnitude and correlates of altered bone mineral density in type 2 diabetes mellitus patients of central rural India

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20203603 ◽

2020 ◽

Vol 7 (9) ◽

pp. 1380

Author(s):

Ningthoukhongjam Reema ◽

Jyoti Jain ◽

Thangjam Gautam Singh ◽

Shashank Banait

Keyword(s):

Diabetes Mellitus ◽

Bone Mineral Density ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Bone Mineral ◽

Rural India ◽

Diabetic Patients ◽

Mineral Density ◽

Study Results

Background: Diabetes mellitus is fast becoming the epidemic of the 21st century. It is a metabolic disease that affects multiple organ system in the body including bone metabolism and bone mass. There is high prevalence of decreased bone mineral density (BMD) in type 2 diabetes mellitus (T2DM) patients leading to osteoporosis, osteopenia and fracture. The aim of the present study was to find the magnitude and correlates of altered BMD in T2DM patients of central rural India.Methods: This cross-sectional study was carried out at a tertiary care teaching hospital in central rural India from 2014 to 2016. It comprises of 200 T2DM patients with aged ≥35 years. Bone mineral density measurements were done by using peripheral dual energy X-ray absorptiometry (DEXA).Results: Mean age of study subjects was 56.13±11.12 years with 43.5% males and 56.5% females. Our study results showed the magnitude of decreased BMD was 82%. 53% of the study subjects were osteoporotic and 29% were osteopenic. Significant associations were detected between decreased BMD and old age, female gender, high body mass index, high fasting blood sugar, high HbA1c and low serum calcium on multivariate analysis.Conclusions: The prevalence of decreased BMD in patients with T2DM of central rural India is high, especially in females’ patients, obese patients, and uncontrolled diabetic patients. Awareness amongst the health care provider of this changes will directly affect the treatment decisions for patients, thereby preventing osteoporosis, osteopenia and mitigating potential fracture risk.

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Gaps-in-noise test performance in subjects with type 2 diabetes mellitus

Auditory and Vestibular Research ◽

10.18502/avr.v27i4.125 ◽

2018 ◽

Author(s):

Ebrahim Pirasteh ◽

Negin Esmailzadeh ◽

Aghil Absalan ◽

Morteza Hamidi Nahrani ◽

Mahin Nosratzehi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Auditory Processing ◽

Diabetic Group ◽

Case Group ◽

Diabetic Patients ◽

Central Auditory Processing ◽

Clinical Tool

Background and Aim: Hearing loss is one of the complications of the type 2 diabetes mellitus, which commonly affects the central auditory processing. Gap in noise (GIN) test is an appropriate clinical tool for evaluating temporal auditory processing. The purpose of the present research was to compare the results of the GIN test in the diabetic patients with non-diabetic participants.Methods: In this cross-sectional study, 30 subjects with type 2 diabetes (mean age=43.33, SD=4.7 years) and 30 normal hearing subjects (mean age=41.26, SD=6.2 years) were examined by the GIN test. The approximate GIN threshold and the percentage of correct answers were measured in all individuals.Results: The findings showed an increase in the approximate GIN threshold and a decrease in the percentage of correct answers in the diabetic group in comparison with the non-diabetic group (p<0.05). In addition, the GIN threshold in the right ear was lower than the left one in the case group (p<0.05).Conclusion: According to the derived results, the patients with type 2 diabetes mellitus appear to have defects in the temporal resolution domain the auditory stimuli and this disorder affects left ear more than right ear.

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Brainstem auditory responses in type-2 diabetes mellitus

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180718 ◽

2018 ◽

Vol 4 (2) ◽

pp. 522

Author(s):

Siddharth Suresh ◽

Sharwak Ramlan ◽

Gangadhara Somayaji ◽

Nimalka Sequeira

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Auditory Pathway ◽

Study Groups ◽

Diabetic Group ◽

Control Group ◽

Diabetic Patients ◽

Multiple Organs

Background: Diabetes mellitus causes pathophysiological changes at multiple organs. Brainstem Evoked Response Auditory (BERA) represents a non-invasive tool to detect diabetes related sensorineural hearing loss. The aim was to assess diabetes related central auditory pathway involvement using BERA.Methods: The study comprises two groups, (i) Diabetic group (n=15), (ii) Control group (n=15). The controls were matched for age and sex with the study group. BERA was done for all these patients after detailed clinical examination and relevant blood investigations. Results: There was significant latency differences found in wave III, V and interpeak latencies I-III, III-V and I-V between control and study groups at 70 dBnHL and 80 dBnHL. At 90 dBnHL the diabetic group demonstrated significant latency differences in waves I, III and V and interpeak I-III, III-V and I-V compared to controls. The duration of DM was 5-10 years in 8 patients (53.3%) out of which 7 subjects (87.5%) had prolonged BERA. 7 patients (46.6%) were diabetic for more than 10 years of which all patients (100%) had prolonged latencies.Conclusions: The wave I latency was found non significant which suggests that the pathway from 8th nerve to cochlear nucleus is not affected in diabetic patients. The delay in latencies III and V and interpeak latencies I-III, III-V and I-V in diabetic patients compared to the controls suggests brainstem and midbrain involvement. So the study suggests that BERA helps in early detection of central neuronal axis involvement in type-2 diabetes mellitus.

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Association of Major Dietary Patterns with General and Abdominal Obesity in Iranian Patients with Type 2 Diabetes Mellitus

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000233 ◽

2015 ◽

Vol 85 (3-4) ◽

pp. 145-155 ◽

Cited By ~ 9

Author(s):

Marjan Ghane Basiri ◽

Gity Sotoudeh ◽

Mahmood Djalali ◽

Mohammad Reza Eshraghian ◽

Neda Noorshahi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Abdominal Obesity ◽

Dietary Patterns ◽

Dietary Pattern ◽

Diabetic Patients ◽

General Obesity ◽

Healthy Dietary Pattern

Abstract. Background: The aim of this study was to identify dietary patterns associated with general and abdominal obesity in type 2 diabetic patients. Methods: We included 728 patients (35 - 65 years) with type 2 diabetes mellitus in this cross-sectional study. The usual dietary intake of individuals over 1 year was collected using a validated semi-quantitative food frequency questionnaire. Weight, height, and waist circumference were measured according to standard protocol. Results: The two major dietary patterns identified by factor analysis were healthy and unhealthy dietary patterns. After adjustment for potential confounders, subjects in the highest quintile of the healthy dietary pattern scores had a lower odds ratio for the general obesity when compared to the lowest quintile (OR = 0.45, 95 % CI = 0.26 - 0.79, P for trend = 0.02), while patients in the highest quintile of the unhealthy dietary pattern scores had greater odds for the general obesity (OR = 3.2, 95 % CI = 1.8 - 5.9, P for trend < 0.001). There were no significant associations between major dietary patterns and abdominal obesity, even after adjusting for confounding factors. Conclusion: This study shows that in patients with type 2 diabetes mellitus, a healthy dietary pattern is inversely associated and an unhealthy dietary pattern is directly associated with general obesity.

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ESTIMATION OF SERUM FERRITIN LEVELS IN TYPE 2 DIABETIC PATIENTS AND ITS RELATION WITH HbA1C LEVEL.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i8.456 ◽

2019 ◽

Vol 3 (8) ◽

Author(s):

Shah Namrata Vinubhai ◽

Pardeep Agarwal ◽

Bushra Fiza ◽

Ramkishan Jat

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Blood Sugar ◽

Serum Ferritin ◽

Inflammatory Marker ◽

Control Group ◽

Diabetic Patients ◽

Positive Correlation

Background: Serum ferritin is known as an index for body iron stores also as an inflammatory marker and it is influenced by several disease. We were looking for a correlation between HbA1c and S. Ferritin in type 2 DM. Methodology: The present study a total of 150 participants were enrolled of which 100 were confirmed cases of Type 2 Diabetes Mellitus and rest 50 age and sex matched healthy subjects constituted the control group. All were screened for HbA1c, Fasting blood sugar, Post prandial blood sugar and S.Ferritin. Results: A highly significant variation and positive correlation was observed with respect to S.Ferritin and HbA1c levels. Mean S.Ferritin was high in the subgroup with poor glycemic control. Conclusion: The fasting, post prandial sugar levels, HbA1c and S.Ferritin were significantly higher in the diabetic subjects. This study shows a positive correlation between HbA1c and S. Ferritin levels. So we can conclude that in diabetic patients S. Ferritin may serve as an independent marker of poor glycemic and metabolic control. Keywords: Serum ferritin, Type 2 Diabetes Mellitus, HbA1c.

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