期刊
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
卷 107, 期 6, 页码 E2405-E2416出版社
ENDOCRINE SOC
DOI: 10.1210/clinem/dgac099
关键词
bone turnover markers; skin intrinsic fluorescence; advanced glycation end products; estimated glomerular filtration rates; proliferative diabetic retinopathy; diabetic peripheral neuropathy
资金
- Division of Diabetes Endocrinology and Metabolic Diseases of the National Institute of Diabetes and Digestive and Kidney Disease [U01 DK094176, U01 DK094157]
- National Eye Institute
- National Institute of Neurologic Disorders and Stroke
- General Clinical Research Centers Program (1993-2007)
- Clinical Translational Science Center Program (2006-present), Bethesda, Maryland, USA
- Abbott Diabetes Care (Alameda, CA, USA)
- Animas (Westchester, PA, USA)
- Bayer Diabetes Care (North America Headquarters, Tarrytown, NY, USA)
- Becton Dickinson (Franklin Lakes, NJ, USA)
- Eli Lilly (Indianapolis, IN, USA)
- Extend Nutrition (St. Louis, MO, USA)
- Insulet Corporation (Bedford, MA, USA)
- Lifescan (Milpitas, CA, USA)
- Medtronic Diabetes (Minneapolis, MN, USA)
- Nipro Home Diagnostics (Ft. Lauderdale, FL, USA)
- Nova Diabetes Care (Billerica, MA, USA)
- Omron (Shelton, CT, USA)
- Perrigo Diabetes Care (Allegan, MI, USA)
- Roche Diabetes Care (Indianapolis, IN, USA)
- Sanofi-Aventis (Bridgewater, NJ, USA)
Poor glycemic control is associated with reduced bone formation in T1D patients, while reduced kidney function is associated with increased bone resorption and formation.
Context Type 1 diabetes (T1D) is characterized by high fracture risk, yet little is known regarding diabetes-related mechanisms or risk factors. Objective Determine whether glycemic control, advanced glycation end products (AGEs), and microvascular complications are associated with bone turnover markers among older T1D adults. Design Cross-sectional. Setting Epidemiology of Diabetes Interventions and Complications study (6 of 27 clinical centers). Participants 232 T1D participants followed for >30 years. Exposures Glycemic control ascertained as concurrent and cumulative hemoglobin A1c (HbA1c); kidney function, by estimated glomerular filtration rates (eGFR); and AGEs, by skin intrinsic fluorescence. Main Outcome Measures Serum procollagen 1 intact N-terminal propeptide (PINP), bone-specific alkaline phosphatase (bone ALP), serum C-telopeptide (sCTX), tartrate-resistant acid phosphatase 5b (TRACP5b), and sclerostin. Results Mean age was 59.6 +/- 6.8 years, and 48% were female. In models with HbA1c, eGFR, and AGEs, adjusted for age and sex, higher concurrent HbA1c was associated with lower PINP [beta -3.4 pg/mL (95% CI -6.1, -0.7), P = 0.015 for each 1% higher HbA1c]. Lower eGFR was associated with higher PINP [6.9 pg/mL (95% CI 3.8, 10.0), P < 0.0001 for each -20 mL/min/1.73 m(2) eGFR], bone ALP [1.0 U/L (95% CI 0.2, 1.9), P = 0.011], sCTX [53.6 pg/mL (95% CI 32.6, 74.6), P < 0.0001], and TRACP5b [0.3 U/L (95% CI 0.1, 0.4), P = 0.002]. However, AGEs were not associated with any bone turnover markers in adjusted models. HbA1c, eGFR, and AGEs were not associated with sclerostin levels. Conclusions Among older adults with T1D, poor glycemic control is a risk factor for reduced bone formation, while reduced kidney function is a risk factor for increased bone resorption and formation.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据
分享论文
