Bone metabolism in male patients with type 2 diabetes

Abstract

Few reports are available on bone turnover in type 2 diabetes. Impaired bone turnover in type 2 diabetes appears to result from decreased bone formation. Studies also suggest that poor glycaemic control in type 2 diabetes may contribute to osteopaenia. The aim of this study was to investigate biochemical markers of bone turnover in males with poorly controlled type 2 diabetes and look for correlations with glycaemic control and gonadal and hypophyseal hormonal axis. Consecutive male patients with poorly controlled type 2 diabetes and attending the internal medicine department during a period of 6 months were enrolled. The patients were receiving oral hypoglycaemic agents (metformin or sulphonylureas or both). None of the patients had any evidence of macroangiopathy, nephropathy or neuropathy. Only two patients had proliferative retinopathy. Serum osteocalcin, crosslaps (C-telopeptide, CTx), parathyroid hormone (PTH), testosterone, oestrogen, prolactin, follicle-stimulating hormone (FSH) and luteinising hormone (LH) were measured in 35 patients and 35 controls. The mean age of the study population was 53.7 (10.3) years (range: 50.2-57.3) and the mean disease duration was 8.6 (6.0) years (range: 6.5-10.7). No differences between patients and controls were observed in serum calcium, phosphorus, creatinine, albumin, PTH, CTx, oestrogen, testosterone, LH, FSH, prolactin and urinary calcium. Patients had lower serum levels of osteocalcin than controls with a significant statistical difference [15.3 (4.1) vs 18.3 (5.3), p=0.012]. There was a negative significant statistical correlation between CTx levels and HbA1c (r=-0.41, p< 0.05). Our study suggested that bone formation is altered in type 2 diabetes and that bone turnover is affected by glycaemic control status.

Metabolic Syndrome and Central Fat Distribution Are Related to Lower Serum Osteocalcin Concentrations

“…The association between DM and low bone turnover has recently been reported [22,23,24,25]. In the present study, mean serum osteocalcin was significantly lower in patients with FPG ≥100 mg/dl and in diabetic patients when compared to the patients with normal blood glucose.…”

Distinct effects of pioglitazone and metformin on circulating sclerostin and biochemical markers of bone turnover in men with type 2 diabetes mellitus

“…Another marker of bone formation, osteocalcin, particularly the undercarboxylated form, has been implicated in the regulation of insulin secretion (24). However, measurements of serum osteocalcin in patients with T2DM have provided conflicting results showing either no change or decrease (23,25,26,27,28,29). We did not measure serum osteocalcin, but a significant positive relationship with serum P1NP has been previously reported in patients with T2DM (23,28).…”

Bone Turnover Markers in Patients with Type 2 Diabetes and Their Correlation with Glycosylated Haemoglobin Levels

“…The use of biochemical markers of bone turnover has shown promise for the evaluation and monitoring of changes in bone metabolism during chronic diseases or therapy, 1 however there are few crosssectional reports available on bone turnover markers in patients with type 2 diabetes. 11,12 In the present prospective, longitudinal study, the effects of metabolic control with respect to HbA 1c levels in type 2 diabetes on biochemical markers of bone turnover were investigated. We found a decrease in the bone turnover markers for bone resorption and bone formation, and a positive correlation between glycaemic control and bone turnover markers.…”