Bone metabolism in type 2 diabetes mellitus

Isaia, Giancarlo; Ardissone, P; Stefano, Marco Di; Ferrari, Daniela; Martina, V.; Porta, Massimo; Tagliabue, M.; Molinatti, G. M.

doi:10.1007/s005920050142

Cited by 93 publications

(72 citation statements)

References 8 publications

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“…Furthermore, multiple regression analysis showed that the number of complications was associated with decreased 25-OHD concentrations in type 2 diabetes patients, suggesting that the progress of diabetic microangiopathy is associated with the decrease of serum concentration of 25-OHD. It has been reported that decreased bone mineral content was found in type 1 diabetes patients and insulintreated type 2 diabetes patients, whereas both increased and decreased bone mass were found in type 2 diabetes patients treated without insulin [18,28,29]. In the present study, we showed that serum concentrations of 25-OHD in insulin-treated type 2 diabetes patients were significantly lower than those in type 2 diabetes patients treated with oral hypoglycemic agents and those in patients without medicine.…”

Section: Discussionsupporting

confidence: 47%

“…Both the increase in bone turnover markers and the decrease in bone formation have been reported in diabetic populations [9,18]. It has been reported that impaired vitamin D metabolism exists in spontaneously diabetic GK rats [19], and that chronic insulin-deficiency results in a decrease in 1-α hydroxylase activity and an increase in 24-hydroxylase activity in chronic streptozotocin-induced diabetic rat [20].…”

Section: Discussionmentioning

confidence: 99%

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Hypovitaminosis D in Type 2 Diabetes Mellitus: Association with Microvascular Complications and Type of Treatment

et al. 2006

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Abstract. The prevalence of hypovitaminosis D has been recently reevaluated, and diabetes is considered as a risk factor for osteoporosis. We studied the association of the prevalence of hypovitaminosis D with the clinical features of diabetes. We conducted the observational study in 581 Japanese patients with type 2 diabetes mellitus and 51 normal subjects, and analyzed the relationship between serum 25-hydroxyvitamin D (25-OHD) concentration and the clinical features associated with type 2 diabetes. Mean serum 25-OHD concentration in type 2 diabetes patients was 17.0 ± 7.1 ng/ml (Mean ± SD) in winter, and was not statistically different from normal population (17.5 ± 3.6 ng/ml). The prevalence of hypovitaminosis D (<20 ng/ml) was 70.6%. Serum concentrations of 25-OHD were associated with HbA1c (P = 0.013), age (P = 0.070) and serum albumin (P<0.001), but were not related to BMI or the duration of diabetes. The levels of 25-OHD were significantly lower in the population with apparent microvascular complications, although serum creatinine levels were below 2.0 mg/dl. Serum 25-OHD concentrations in the group treated with insulin (15.4 ± 6.5 ng/ml) was lower than those in the patients treated with diet alone (20.8 ± 7.6 ng/ml) and with oral hypoglycemic agents (17.3 ± 7.0 ng/ml). Furthermore, the highest incidence of osteoporotic fracture and/or back deformity was observed in insulin-treated patients with hypovitaminosis D. In conclusion, these results suggest that microvascular complications and insulin treatment in type 2 diabetes patients are associated with the co-existence of hypovitaminosis D, and that hypovitaminosis D in insulin-treated patients is possibly related to the risk of osteoporotic fracture.

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Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Hypovitaminosis D in Type 2 Diabetes Mellitus: Association with Microvascular Complications and Type of Treatment

et al. 2006

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“…However, studies in rodent models of type 2 DM and in rodents fed high-fat diets have demonstrated a reduction in osteoblast recruitment and mineral apposition rate and an increase in osteoclastogenesis, resulting in an imbalance between bone formation and resorption (42,43). Cross-sectional findings in humans further support these data, as serum markers of bone formation, such as osteocalcin, are lower and markers of bone resorption, such as C-terminal telopeptide of type 1 collagen, are elevated in participants with type 2 DM (44,45). Increased bone resorption may be mediated by the formation of advanced glycation end products, which stimulate osteoclast activity and may lead to an uncoupling of bone formation and resorption (46).…”

Section: Pritchard Et Almentioning

confidence: 87%

Association of larger holes in the trabecular bone at the distal radius in postmenopausal women with type 2 diabetes mellitus compared to controls

Pritchard¹,

Giangregorio²,

Atkinson³

et al. 2011

Arthritis Care & Research

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Objective. Adults with type 2 diabetes mellitus (DM) have an elevated fracture risk despite normal areal bone mineral density (aBMD). The study objective was to compare trabecular bone microarchitecture of postmenopausal women with type 2 DM and women without type 2 DM.Methods. An extremity 1T magnetic resonance imaging system was used to acquire axial images (195 ؋ 195 ؋ 1,000 m 3 voxel size) of the distal radius of women recruited from outpatient clinics or by community advertisement. Image segmentation yielded geometric, topologic, and stereologic outcomes, i.e., number and size of trabecular bone network holes (marrow spaces), endosteal area, trabecular bone volume fraction, nodal and branch density, and apparent trabecular thickness, separation, and number. Lumbar spine (LS) and proximal femur BMD were measured with dual x-ray absorptiometry. Microarchitectural differences were assessed using linear regression and adjusted for percent body fat, ethnicity, timed up-and-go test, Charlson Index, and calcium and vitamin D intake; aBMD differences were adjusted for body mass index (BMI). Results. Women with type 2 DM (n ‫؍‬ 30, mean ؎ SD age 71.0 ؎ 4.8 years) had larger holes (؉13.3%; P ‫؍‬ 0.001) within the trabecular bone network than women without type 2 DM (n ‫؍‬ 30, mean ؎ SD age 70.7 ؎ 4.9 years). LS aBMD was greater in women with type 2 DM; however, after adjustment for BMI, LS aBMD did not differ between groups. Conclusion. In women with type 2 DM, the average hole size within the trabecular bone network at the distal radius is greater compared to controls. This may explain the elevated fracture risk in this population.

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“…O LDER WHITE WOMEN with type 2 diabetes have higher areal BMD than women without diabetes, even after adjusting for body size, (1)(2)(3)(4)(5) but not much evidence exists for older white men and black adults or for volumetric BMD. Some large studies have found higher BMD among white men with type 2 diabetes, (2,4) but others reported nonsignificant differences.…”

Section: Introductionmentioning

confidence: 99%

Diabetes Is Associated Independently of Body Composition With BMD and Bone Volume in Older White and Black Men and Women: The Health, Aging, and Body Composition Study

Strotmeyer

Cauley

Schwartz

et al. 2004

Journal of Bone and Mineral Research

189

117

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The association between type 2 diabetes, BMD, and bone volume was examined to determine the effect of lean and fat mass and fasting insulin in the Health, Aging, and Body Composition Study, which included white and black well-functioning men and women 70-79 years of age (N ‫؍‬ 2979). Diabetes predicted higher hip, whole body, and volumetric spine BMD, and lower spine bone volume, independent of body composition and fasting insulin.Introduction: The purpose of this study was to determine if the association between type 2 diabetes and higher BMD observed in older white women is seen in elderly white men and blacks and to evaluate if higher BMD in diabetic individuals is accounted for by lean mass, fat mass, or fasting insulin differences. Materials and Methods:In the Health, Aging, and Body Composition Study, which included white and black well-functioning men and women 70 -79 years of age (N ϭ 2979), 19% of participants had diabetes at baseline. Of those with diabetes, 57% were men, and 62% were black. Multivariate linear regression models examined independent effects of diabetes, lean mass, fat mass, visceral fat, and fasting insulin on BMD and bone volume while adjusting for relevant covariates. Results and Conclusions: Fasting insulin, visceral fat, and volumetric spine BMD, assessed by CT, and lean mass, fat mass, and total hip and whole body BMD, assessed by DXA, were higher (p Յ 0.05 for all) for those with diabetes. Hip BMD was higher in white men (0.99 Ϯ 0.14 versus 0.93 Ϯ 0.14 g/cm

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Bone metabolism in type 2 diabetes mellitus

Cited by 93 publications

References 8 publications

Hypovitaminosis D in Type 2 Diabetes Mellitus: Association with Microvascular Complications and Type of Treatment

Hypovitaminosis D in Type 2 Diabetes Mellitus: Association with Microvascular Complications and Type of Treatment

Association of larger holes in the trabecular bone at the distal radius in postmenopausal women with type 2 diabetes mellitus compared to controls

Diabetes Is Associated Independently of Body Composition With BMD and Bone Volume in Older White and Black Men and Women: The Health, Aging, and Body Composition Study

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