Correlation of Osteoporosis in Patients With Newly Diagnosed Type 2 Diabetes: A Retrospective Study in Chinese Population

Overview

Journal Front Endocrinol (Lausanne)

Specialty Endocrinology

Date 2021 May 31

PMID 34054717

Citations 17

Authors

Yuhua Wen

Huijuan Li

Xiaoya Zhang

Peipei Liu

Jing Ma

Liya Zhang

Keqin Zhang

Lige Song

Affiliations

Soon will be listed here.

Abstract

This study aimed to explore the risk factors attributed to osteoporosis in newly type 2 diabetes mellitus (T2DM) patients. This study aimed to recruit 244 T2DM patients and 218 non-diabetic controls. We collected demographic characteristics, medical history, bone mineral density and biomarkers including bone specific alkaline phosphatase (BALP), osteocalcin, N-terminal peptide of type I procollagen (P1NP), tartrate-resistant acid phosphatase 5b (TRCAP-5b), β-Cross Laps of type I collagen-containing cross-linked C-telopeptide (β-CTX), 25-hydroxyvitamin D, parathyroid hormone were recorded or detected. Bone mineral density (BMD) was our primary outcome. Based on the result of BMD, we divided both the control group and T2DM group into three subgroups: normal bone mass, osteopenia and osteoporosis. In control group, we found age, sex, menopausal status, BMI, P1NP, BALP, TRACP-5b, osteocalcin, and corrected serum calcium are differential among three subgroups. In T2DM group, we found age, sex, menopausal status, drinking status, BMI, HbA1c, TRACP-5b and OC were differential among three subgroups. In T2DM and control groups, age, female, postmenopausal status, BALP, TRACP-5b and osteocalcin were positively correlated while BMI was negatively correlated with osteoporosis. In control group, β-CTX was positively correlated with osteoporosis. In T2DM group, HbA1c and corrected serum calcium concentration were positively correlated with osteoporosis. After further adjustment of age, BMI in male, TRACP-5b was positively correlated with the risk of osteoporosis in newly diagnosed T2DM. After adjusted of age, BMI and menopausal status in female, OC was positively correlated with the risk of osteoporosis in newly diagnosed T2DM and controls. In female T2DM, BALP and P1NP were positively correlated with the risk of osteoporosis. In conclusion, age, BMI and menopausal status are common risk factors for osteoporosis in diabetic and non-diabetic patients, however TRACP-5b, BALP and osteocalcin are special risk factors for osteoporosis in newly diagnosed T2DM patients but not non-diabetic patients, which may be applied to identify osteoporosis risk in T2DM patients, but this result needs to be proven with fracture data.

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References

Botolin S, Faugere M, Malluche H, Orth M, Meyer R, McCabe L . Increased bone adiposity and peroxisomal proliferator-activated receptor-gamma2 expression in type I diabetic mice. Endocrinology. 2005; 146(8):3622-31. PMC: 1242186. DOI: 10.1210/en.2004-1677. View

Christensen M, Lund A, Calanna S, Jorgensen N, Holst J, Vilsboll T . Glucose-Dependent Insulinotropic Polypeptide (GIP) Inhibits Bone Resorption Independently of Insulin and Glycemia. J Clin Endocrinol Metab. 2017; 103(1):288-294. DOI: 10.1210/jc.2017-01949. View

Napoli N, Chandran M, Pierroz D, Abrahamsen B, Schwartz A, Ferrari S . Mechanisms of diabetes mellitus-induced bone fragility. Nat Rev Endocrinol. 2016; 13(4):208-219. DOI: 10.1038/nrendo.2016.153. View

Adil M, Khan R, Kalam A, Venkata S, Kandhare A, Ghosh P . Effect of anti-diabetic drugs on bone metabolism: Evidence from preclinical and clinical studies. Pharmacol Rep. 2017; 69(6):1328-1340. DOI: 10.1016/j.pharep.2017.05.008. View

Cordes C, Baum T, Dieckmeyer M, Ruschke S, Diefenbach M, Hauner H . MR-Based Assessment of Bone Marrow Fat in Osteoporosis, Diabetes, and Obesity. Front Endocrinol (Lausanne). 2016; 7:74. PMC: 4921741. DOI: 10.3389/fendo.2016.00074. View

Ferrari S, Abrahamsen B, Napoli N, Akesson K, Chandran M, Eastell R . Diagnosis and management of bone fragility in diabetes: an emerging challenge. Osteoporos Int. 2018; 29(12):2585-2596. PMC: 6267152. DOI: 10.1007/s00198-018-4650-2. View

Cho N, Shaw J, Karuranga S, Huang Y, da Rocha Fernandes J, Ohlrogge A . IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018; 138:271-281. DOI: 10.1016/j.diabres.2018.02.023. View

Sheu Y, Amati F, Schwartz A, Danielson M, Li X, Boudreau R . Vertebral bone marrow fat, bone mineral density and diabetes: The Osteoporotic Fractures in Men (MrOS) study. Bone. 2017; 97:299-305. PMC: 5367972. DOI: 10.1016/j.bone.2017.02.001. View

Edwards B, Brooks E, Langman C . Osteoporosis screening of postmenopausal women in the primary care setting: a case-based approach. Gend Med. 2005; 1(2):70-85. DOI: 10.1016/s1550-8579(04)80013-5. View

10.

Schwartz A, Vittinghoff E, Sellmeyer D, Feingold K, de Rekeneire N, Strotmeyer E . Diabetes-related complications, glycemic control, and falls in older adults. Diabetes Care. 2007; 31(3):391-6. PMC: 2288549. DOI: 10.2337/dc07-1152. View

11.

Holst J, Vilsboll T, Deacon C . The incretin system and its role in type 2 diabetes mellitus. Mol Cell Endocrinol. 2008; 297(1-2):127-36. DOI: 10.1016/j.mce.2008.08.012. View

12.

Tanaka K, Yamaguchi T, Kanazawa I, Sugimoto T . Effects of high glucose and advanced glycation end products on the expressions of sclerostin and RANKL as well as apoptosis in osteocyte-like MLO-Y4-A2 cells. Biochem Biophys Res Commun. 2015; 461(2):193-9. DOI: 10.1016/j.bbrc.2015.02.091. View

13.

Janghorbani M, van Dam R, Willett W, Hu F . Systematic review of type 1 and type 2 diabetes mellitus and risk of fracture. Am J Epidemiol. 2007; 166(5):495-505. DOI: 10.1093/aje/kwm106. View

14.

Alswat K . Gender Disparities in Osteoporosis. J Clin Med Res. 2017; 9(5):382-387. PMC: 5380170. DOI: 10.14740/jocmr2970w. View

15.

Jules J, Feng X . In vitro investigation of the roles of the proinflammatory cytokines tumor necrosis factor-α and interleukin-1 in murine osteoclastogenesis. Methods Mol Biol. 2014; 1155:109-23. DOI: 10.1007/978-1-4939-0669-7_10. View

16.

An Y, Zhang H, Wang C, Jiao F, Xu H, Wang X . Activation of ROS/MAPKs/NF-κB/NLRP3 and inhibition of efferocytosis in osteoclast-mediated diabetic osteoporosis. FASEB J. 2019; 33(11):12515-12527. PMC: 6902677. DOI: 10.1096/fj.201802805RR. View

17.

Zhang Z, Ou Y, Sheng Z, Liao E . How to decide intervention thresholds based on FRAX in central south Chinese postmenopausal women. Endocrine. 2013; 45(2):195-7. PMC: 3924028. DOI: 10.1007/s12020-013-0076-y. View

18.

Zhong Q, Itokawa T, Sridhar S, Ding K, Xie D, Kang B . Effects of glucose-dependent insulinotropic peptide on osteoclast function. Am J Physiol Endocrinol Metab. 2006; 292(2):E543-8. DOI: 10.1152/ajpendo.00364.2006. View

19.

Schwartz A, Vittinghoff E, Bauer D, Hillier T, Strotmeyer E, Ensrud K . Association of BMD and FRAX score with risk of fracture in older adults with type 2 diabetes. JAMA. 2011; 305(21):2184-92. PMC: 3287389. DOI: 10.1001/jama.2011.715. View

20.

Abrahamsen B, Bonnevie-Nielsen V, Ebbesen E, Gram J, Beck-Nielsen H . Cytokines and bone loss in a 5-year longitudinal study--hormone replacement therapy suppresses serum soluble interleukin-6 receptor and increases interleukin-1-receptor antagonist: the Danish Osteoporosis Prevention Study. J Bone Miner Res. 2000; 15(8):1545-54. DOI: 10.1359/jbmr.2000.15.8.1545. View