Serum markers of bone fragility in type-2 diabetes mellitus

Abstract

Patients with type-2 diabetes mellitus (T2DM) have normal or increased bone mineral density (BMD) but despite that, they are characterized by an increased hip and vertebral fracture risk that involves the alteration of bone quality and not the reduction in bone mass. BMD is utilized for the diagnosis and evaluation of osteoporosis, but BMD itself cannot provide an accurate diagnosis of the individuals at increased risk of fracture and, therefore, studies have focused on identifying other risk factors that are partially or fully independent of BMD. The fracture risk score tool-FRAX® models provide information about a 10-year probability of osteoporotic fractures, but do not include risk factors specific to illness such as diabetes duration, diabetes drug therapy, glycemic control, or the presence of micro-vascular complications. Multiple markers have been investigated to provide information on the risk of fractures in patients with T2DM such as: advanced glycation end products (AGEs), insulin-like growth factor-I (IGF-I), osteocalcin (OC), adiponectin, and sclerostin, but epidemiological studies did not provide homogeneous information regarding the link between these markers and bone fragility in T2DM subjects. Markers that increase the accuracy of fracture risk estimation in patients with T2DM need to be identified and employed in current medical practice. Keywords  diabetes mellitus, bone fragility, markers of fracture risks Highlights  Patients with type 2 diabetes mellitus have significantly higher scores in over-vigilance and inhibition schematic domains.  Epidemiological studies do not provide unitary information on the association between markers of bone fragility and fracture risk in T2DM.

The predictive role of monocyte-lymphocyte ratio and plateletlymphocyte ratio in postmenopausal osteoporosis

“…In another paper published in 2017, the relationship between low bone mineral density and neutrophil lymphocyte ratio and platelet lymphocyte ratio was studied in postmenopausal women. While the thrombocyte lymphocyte ratio was found to be statistically significantly higher in the group with low bone mineral density compared to the group with normal bone mineral density (p = 0.008), such a relationship was not shown in the neutrophil lymphocyte ratio [12][13][14].…”

Primary hyperparathyroidism can generate recurrent pancreatitis and secondary diabetes mellitus – A case report

“…Diabetes is associated with pancreatic disorders such as ductal pancreatic adenocarcinoma, hemochromatosis, pancreatitis, cystic fibrosis, and pancreatic surgery, but also with the alteration of bone quality (31). The prevalence of diabetes in association with pancreatitis was estimated, according to different studies, at 25-80% (32).…”