Leptin is an independent determinant of bone mineral density in men with type 2 diabetes mellitus

Василькова, О. Н.; Мохорт, Т. В.; Шаршакова, Т. М.; Hayashida, Naomi; Takamura, Noboru

doi:10.1007/s00592-011-0266-0

Cited by 16 publications

(9 citation statements)

References 44 publications

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“…Changes in adipokine levels e.g. adiponectin and leptin may also affect bone formation but the available data are contradictory [27–31]. Another potential mechanism for reduced bone strength and skeletal fragility in patients with advanced T2DM may be an increase in circulating cytokines and activation of NFκB [32].…”

Section: Discussionmentioning

confidence: 99%

Hip geometry in diabetic women: Implications for fracture risk

Garg

Chen

Beck³

et al. 2012

Metabolism

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Objective Women with type 2 diabetes mellitus (T2DM) have a higher risk of fractures despite increased bone mineral density (BMD) as compared to women without diabetes. We hypothesized that bone strength is diminished in women with T2DM after accounting for lean body mass, which may contribute to their increased fracture risk. Methods Participants from Women’s Health Initiative Observational Study were included in this cross-sectional study. These analyses include 3 groups of women: 1) T2DM women on diet or oral hypoglycemic agents (n=299); 2) T2DM women on insulin therapy (with or without oral agents) (n=128); and 3) Non-diabetic control women (n=5497). Hip structural analyses were done using the validated Beck’s method on hip scans from dual energy x-ray absorptiometry (DXA). We compared BMD and section modulus (bending strength) at the narrow neck with and without correcting for total body DXA lean body mass. Results Women in all three groups were of similar ages (63.7, 64.6 and 64.2 years, respectively) and heights, but those with T2DM were heavier, with greater lean body weight vs. controls (p<0.001). In both diabetic groups, absolute BMD and section modulus were higher compared with controls. However, after adjusting for total lean body weight, diabetic women on insulin had significantly lower BMD and section modulus. Conclusion Adjusted for lean body weight, the BMD and bending strength in the femoral neck are significantly lower in insulin - treated diabetic women vs. controls. This may represent altered adaptation of bone modeling and explain the higher fracture risk in patients with T2DM.

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Section: Discussionmentioning

confidence: 99%

Hip geometry in diabetic women: Implications for fracture risk

Garg

Chen

Beck³

et al. 2012

Metabolism

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“…BMD and body mass index (BMI) are positively correlated in type 2 patients [11,13,14], and BMI is negatively associated with osteoporosis [14]. Adipose tissue provides mechanical loading but may also increase BMD through the activity of adipocytokines [14] such as adiponectin [15] and leptin [16]. Despite different bone phenotypes, fracture risk is increased in both type 1 and type 2 diabetes, particularly at the femoral neck [1,17].…”

Section: Introductionmentioning

confidence: 99%

A five-year prospective study of bone mineral density in men and women with diabetes: The Fremantle Diabetes Study

et al. 2011

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To examine longitudinally the effect of diabetes on bone structure and metabolism, we measured bone mineral density (BMD) and turnover markers in 26 type 1 (mean age 49 years) and 27 type 2 (mean age 65 years) diabetic patients without known osteoporosis from a community-based sample at baseline and 5 years later. In the 17 type 1 men, BMD fell at the femoral neck (0.804 ± 0.145 vs. 0.769 ± 0.129 g/cm(2); P = 0.003) with no change at lumbar spine or forearm. In the 11 type 2 women, BMD decreased at all sites except spine (femoral neck 0.779 ± 0.119 vs. 0.742 ± 0.090 g/cm(2); P = 0.019). BMD did not fall at any site in type 1 women or type 2 men. There was an increase in serum alkaline phosphatase and trend to higher serum beta carboxyl-terminal type I collagen telopeptide concentrations in the type 1 patients, and a decrease in free testosterone in the type 1 men. These data show that the rate of demineralization at the femoral neck in type 1 men is similar to that in older post-menopausal type 2 women. Changes in biochemical markers suggest that, in type 1 men, there is ineffective bone formation associated with accelerated bone resorption and lower sex steroid bioavailability. These findings may have implications for the clinical management of young male adults with diabetes.

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“…It is also intimately associated with diabetes, serving as an independent marker of bone mineral density [18], as well as correlating with fasting insulin sensitivity [19] in patients with type 2 diabetes. A role of leptin in the wound-healing process has also been suggested [20][21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Expression of leptin and its long-form receptor in the marginal cutaneous tissues of diabetic foot ulcers

Cao

Gao

et al. 2012

Acta Diabetol

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To investigate the relationship between the expression of leptin and its long-form receptor, OB-RL, and wound healing in diabetic foot ulcers. Biopsies from 10 patients with diabetic foot ulcers (DU group), 10 with non-diabetic foot ulcers (NDU group), and 10 with normal skin (normal control, NC group) were examined. Leptin and OB-RL mRNA and protein levels were assessed using RT-PCR and immunohistochemistry analyses, respectively. The cuticle thickness was significantly greater, and the epidermal layer was significantly lesser in the DU and NDU groups. Leptin protein expression was significantly higher in the DU and NDU than NC group (P < 0.001), whereas OB-RL mRNA and protein expressions were significantly lower in the DU group and significantly higher in the NDU group (P < 0.001). Diabetic foot ulcer duration was negatively correlated with OB-RL protein expression (ρ = -0.671, P = 0.034). Decreased OB-RL may result in reduced leptin signaling in diabetic foot ulcers. Further studies are required to determine whether OB-RL levels are related to the prognosis of diabetic foot ulcers, as well as to explore the use of leptin or mimetics for promoting ulcer healing.

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Leptin is an independent determinant of bone mineral density in men with type 2 diabetes mellitus

Cited by 16 publications

References 44 publications

Hip geometry in diabetic women: Implications for fracture risk

Hip geometry in diabetic women: Implications for fracture risk

A five-year prospective study of bone mineral density in men and women with diabetes: The Fremantle Diabetes Study

Expression of leptin and its long-form receptor in the marginal cutaneous tissues of diabetic foot ulcers

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