Biochemical relationships between bone turnover markers and blood glucose in patients with type 2 diabetes mellitus

Introduction: Patients with type 2 diabetes mellitus develop many complications including osteopenia, which is associated with high fracture risk. Osteocalcin is a non collagenous protein derived from the osteoblasts. Recently, it was found that osteocalcin enhances the pancreatic beta cell proliferation, insulin secretion and protection against type 2 diabetes. Objective: Investigation of the association of serum osteocalcin and other bone turnover markers with blood glucose level and diabetes mellitus duration in type 2 diabetic patients. Subjects and methods: Twenty diagnosed type 2 diabetic patients together with 20 healthy controls were enrolled in this study. Serum osteocalcin, alkaline phosphatase activity and calcium concentrations were measured by commercial ELISA kits. Results: The results showed that type 2 diabetic patients exhibited a significantly lower serum osteocalcin and calcium (p = 0.0001 and 0.002 respectively) and a higher alkaline phosphatase (p = 0.008) compared to the controls. Multiple linear regression analysis revealed that serum osteocalcin was inversely associated with fasting blood glucose and Diabetes Mellitus duration ((beta =-0.018; p = 0.007 and beta =-0.085; p = 0.014 respectively) in Type 2 diabetic patients. In addition, alkaline phosphatase was positively associated (beta = 0.828; p = 0.015) while serum calcium was negatively associated (beta =-0.046; p = 0.048) with Diabetes Mellitus duration. Conclusion: These results refer to the strong association between diabetes and bone turnover markers and call for monitoring of diabetes-associated osteopenia in type 2 diabetic patients. (C) 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.