Osteoporosis in Diabetics and Its Relation to Igf-1

Abstract

Background: Osteoporosis is a global age-related health problem in both male and female elderly, affecting the microstructure of bone. Although osteoporosis is normally associated with old age and estrogen deficiency, diabetes mellitus (DM), also contributes to and/or aggravates bone loss in osteoporotic patients Diabetes can affect bone through multiple pathways including obesity, changes in insulin levels, higher concentrations of advanced glycation end products in collagen, microangiopathy, inflammation and lower insulin-like growth factor-I (IGF1). Aim of the work: Studying the alterations in bone metabolism in diabetic patients and its relation to IGF1. Subjects and methods: The study included 83 participants, 53 of them were diabetics, and 30 participants were age and sex matched healthy subjects. Patients with hepatic or renal diseases, post-menopausal females,males older than 50 years, steroid medication intake,smoking, alcohol intake and other endocrinal disease causing osteoporosis were excluded. Blood samples were obtained from all subjects to measure calcium,phosphorus, parathyroid hormone, HBA1c and IGF1. DEXA scan were done to all subjects to evaluate bone quality. Results: IGF1 concentration did not show any significant difference between total diabetic patients and control but its concentration was lower in type 1 DM than type 2 but did not reach a significant value. Whole diabetic group showed significantly lower BMD when compared to controls. In addition , type 1 DM subgroup showed lower BMD than type 2 DM subgroup .Osteoporosis and/or osteopenia showed significantly higher incidence in whole diabetic group, type 1 DM subgroup when compared to controls and in type 1 DM subgroup when compared to type 2 DM subgroup,IGF1 was negatively correlated with HbA1C in type 1 DM. No other significant differences were found in laboratory data between different studied groups except for HbA1c which was significantly higher in whole diabetic groups in comparison to control group. Conclusion: Diabetes mellitus either type 1 or type 2 can lead to bone defects but in type 1 DM more damage to bone occurred than in type 2, IGF1 concentration is lower in type 1DM than in type 2 DM and is negatively correlated with HA1C in type 1 DM.