4.4 Article

Characteristics of bone metabolism in postmenopausal women with newly diagnosed type 2 diabetes mellitus

Journal

CLINICAL ENDOCRINOLOGY
Volume 95, Issue 3, Pages 430-438

Publisher

WILEY
DOI: 10.1111/cen.14501

Keywords

type 2 diabetes; bone metabolism; fracture; bone formation; postmenopausal women

Funding

  1. Shanghai Science and Technology Foundation [19ZR1448600]
  2. Clinical Science and Technology Innovation Program of Hospital Development Center [SHDC12018X10]
  3. Science and Technology Innovation Project of Health System in Putuo District, Shanghai [ptkwws201930]
  4. Shanghai Municipal Health Commission [201840217]
  5. Program of Outstanding Scientists in Tongji Hospital [RCQD1701]
  6. National Natural Science Foundation of China [81800783]
  7. Tongji Hospital [ITJ(ZD)1904]

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Patients with newly diagnosed T2DM may exhibit higher levels of bone alkaline phosphatase and lower levels of procollagen type I intact N-terminal, osteocalcin, and parathyroid hormone compared to non-diabetic individuals. Glycated hemoglobin is negatively correlated with bone turnover markers in both T2DM patients and non-diabetic individuals.
Objective The characteristics of bone metabolism in T2DM are still controversial. This study aims to recognize bone turnover features in patients with newly diagnosed T2DM who have never been treated with anti-diabetic drugs and further explore the possible factors contributing to their impaired bone turnover. Materials and Methods An analytic sample of 88 patients with newly diagnosed T2DM and 152 non-diabetic control individuals were studied. All the participants were postmenopausal women. Demographics variables and clinical history were recorded. We measured lipid profile, glucose metabolism, bone turnover markers indices as well as their related hormones, serum calcium and phosphorus. Bone mineral density was detected by dual-energy X-ray absorptiometry. We compared the differences in bone turnover markers and their regulating hormones between two groups and further analysed the factors related to bone turnover in T2DM. Results Compared with the control group, patients with T2DM had a higher level of bone alkaline phosphatase (BALP), lower levels of procollagen type I intact N-terminal (P1NP), osteocalcin (OC) and parathyroid hormone (PTH). Multiple linear regression analysis showed that in patients with T2DM, HbA1c was negatively correlated with P1NP and OC. For patients without diabetes, HbA1c was negatively related to BALP and OC. Conclusions Patients with newly diagnosed T2DM may have impaired osteoblastic maturation and bone formation, which may be mainly attributed to hyperglycaemia.

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