Osteopenia associated with non-insulin-dependent diabetes mellitus: what are the causes?

Gregorio, F. Di; Cristallini, S.; Santeusanio, Fausto; Filipponi, P; Fumelli, P.

doi:10.1016/0168-8227(94)90126-0

Cited by 127 publications

(104 citation statements)

References 52 publications

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“…Our results in the patients with Type II diabetes suggest, however, increased bone resorption. In contrast to previous studies, the increased bone resorption was not related to medium-term metabolic control [22]. It has been suggested that bone loss is less in patients with Type II diabetes who are receiving insulin than those receiving oral hypoglycaemic agents [23].…”

Section: Sscontrasting

confidence: 53%

Bone mineral density, collagen type 1 α 1 genotypes and bone turnover in premenopausal women with diabetes mellitus

et al. 1998

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Diabetic osteopenia is a recognised but neglected complication of diabetes mellitus. Reduced bone mass and an overall twofold increase in fracture rate has been shown to occur in Type I (insulin-dependent) diabetes mellitus [1]. The situation in Type II (non-insulin-dependent) diabetes mellitus is less clear-cut, with reports of increased, decreased or unaltered bone mass reflecting the underlying heterogeneity of Type II diabetes [2]. The pathogenesis of diabetic osteopenia remains unclear. The reduction in bone mass could be due, in part, to a failure to reach peak bone mass especially in younger subjects with Type I diabetes [3] and partly to abnormal bone turnover [4]. In adults net bone loss has been found with a Diabetologia (1998) Summary Osteopenia is a recognised complication of diabetes mellitus which could be due to abnormal bone turnover or disturbances in the calcium/parathyroid hormone/vitamin D axis or both. Genetic factors also play an important part in determining bone mass although this has not been studied in diabetes.Recently a polymorphism of the collagen type 1 a 1 (COL1A1) gene has been shown to be associated with low bone mass in British women. To identify subjects with diabetes who may be at risk of developing osteoporosis and fractures, we analysed bone mineral density in relation to the biochemical markers of bone turnover, calcium homeostasis and the COL1A1 genotype in a group of premenopausal women with Type I (insulin-dependent) diabetes mellitus (n = 31), Type II (non-insulin dependent) diabetes mellitus (n = 21) and control subjects (n = 20). Bone mineral density was lower at the femoral neck in the subjects with Type I diabetes (p = 0.08) as were serum 25-hydroxyvitamin D compared with control subjects (p = 0.023) and this was negatively correlated with serum collagen type 1 C-terminal propeptide (r = ±0.56, p < 0.001). Bone mineral density in Type II diabetes was not different from control subjects, after correction for body mass index. Bone resorption was, however, raised in the Type II diabetic subjects as reflected by the higher urinary deoxypyridinoline values (p = 0.016) and lower collagen type 1 C-terminal propeptide:deoxypyridinoline ratio (p = 0.04). In the whole group studied, subjects with the COL1A1 s' genotype had lower bone mineral density at the femoral neck (p = 0.01) which was partly attributable to a lower body mass index. Following multiple regression analysis body mass index and collagen type 1 C-terminal propeptide concentrations remained determinants of bone mass at all three sites, whereas genotype appeared to be a predictor of bone mass at the femoral neck only. We conclude that measurement of these variables could prove useful in firstly identifying those diabetic women at risk of osteoporosis and secondly guiding therapeutic intervention. [Diabetologia (1998)

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Section: Sscontrasting

confidence: 53%

Bone mineral density, collagen type 1 α 1 genotypes and bone turnover in premenopausal women with diabetes mellitus

et al. 1998

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“…In addition, type-2 diabetic osteoporosis is associated with altered calcium and vitamin D metabolism. Gregorio et al (1994) have demonstrated that bone mineral content is reduced in type-2 diabetic patients. Takizawa et al (2003) have also found diabetic osteopenia in patients with type-2 diabetes.…”

Section: Discussionmentioning

confidence: 99%

A novel rat model for the study of deficits in bone formation in type-2 diabetes

et al. 2007

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Background There is evidence to suggest that impairment in bone formation and/or turnover is associated with the metabolic abnormalities characteristic of type-2 diabetes mellitus. However, bone regeneration/repair in type-2 diabetes has not been modeled. Using Zucker Diabetic Fatty (ZDF) rats (a model of type-2 diabetes) for tibial distraction osteogenesis (DO), we hypothesized that bone formation within the distraction gap would be impaired.Animals and methods Rats were examined for body weight, glycosuria, and glycosemia to confirm the diabetic condition during the study. The rats received placement of the external fixators and osteotomies on the left tibia. Distraction was initiated the following day at 0.2 mm twice a day and continued for 14 days. The lengthened tibiae were harvested and distraction gaps were examined radiographically and histologically.Results We found significant reduction in new bone formation in the distraction gaps of the ZDF rats, both radiographically and histologically, compared to lean rats. We found a decrease in a marker of cellular proliferation in the distraction gaps and increased adipose volume in adjacent bone marrow of the ZDF rats.Interpretation Our findings suggest that this model might be used to study the contributions of leptin resistance, insulin resistance and/or hyperglycemia to impaired osteoblastogenesis in vivo.

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“…27 Gregorio et al observed reduced bone mineral content in poorly controlled diabetic subjects. 8 Interestingly, some other studies had shown diabetes as a promoter for bone health. Barrett-Connor and Holbrook found that women with T2DM had a significantly higher BMD level than women with normal glucose tolerance.…”

Section: Resultsmentioning

confidence: 99%

“…6 But with type 2 diabetes some authors report increased some report decreased and some others report unaltered. [7][8][9] BMD Metabolic bone disease is underestimated in our country due to unawareness of the same, both among patients as well as health providers. Early identification of reduction in bone mass in a diabetic patient may be helpful in preventing the bone loss and future fracture risk.…”

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confidence: 99%

Estimation of bone mineral density among type 2 diabetes mellitus patients in western Odisha

Thakur

2018

Int J Res Med Sci

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Background: Diabetes Mellitus is one of the most common chronic non-communicable diseases in the world. The relationship between type 2 diabetes mellitus (T2DM) and bone mineral density (BMD) has been controversial. Early identification of reduction in bone mass in a diabetic patient may be helpful in preventing the bone loss and future fracture risks. Objective: The aim is to study the effect of T2DM on BMD among patients in western Odisha.Methods: A cross-sectional study was conducted on 120 patients between 40 and 65 years of age which included 60 diabetic and 60 nondiabetic subjects. BMD was measured using qualitative ultrasound and the data were compared among age-matched subjects of both the groups. Statistical analysis was performed using unpaired Student's t-test and test of equality of proportions.Results: No significant difference was observed in bone density of both the groups. On further analyzing the data, incidence of osteoporosis was higher among diabetic subjects, whereas incidence of osteopenia was higher among nondiabetic subjects.Conclusions: Although significant difference in bone mineral density was not observed in both the groups, the incidence of osteoporosis was higher among type 2 diabetics. Hence, all type 2 diabetics should be evaluated for the risk of osteoporosis and should be offered appropriate preventive measures.

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Osteopenia associated with non-insulin-dependent diabetes mellitus: what are the causes?

Cited by 127 publications

References 52 publications

Bone mineral density, collagen type 1 α 1 genotypes and bone turnover in premenopausal women with diabetes mellitus

Bone mineral density, collagen type 1 α 1 genotypes and bone turnover in premenopausal women with diabetes mellitus

A novel rat model for the study of deficits in bone formation in type-2 diabetes

Estimation of bone mineral density among type 2 diabetes mellitus patients in western Odisha

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