The Associations Between Hypovitaminosis D, Higher Pth Levels With Bone Mineral Densities, And Risk Of The 10-Year Probability Of Major Osteoporotic Fractures In Chinese Patients With T2Dm

Yu, Jingjia; Wang, Xiaojing; Jing, Yixuan; Sun, Lin; Tao, Bei; Wang, Weiqing; Ning, Guang; Liu, Jianmin; Zhao, Hongyan

doi:10.4158/ep-2017-0164

Cited by 12 publications

(13 citation statements)

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“…In the current study, we first demonstrated that MF increased Ca level and decreased PTH level in the serum of the diabetic rats. It is accepted that high level of PTH is negatively correlated with BMDs and 1,25(OH) 2 D 3 as well as positively correlated with high risk of bone fracture (Wang et al, 2018 ). In addition, low level of 1,25(OH) 2 D 3 may be linked to development of type 2 diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, hyperglycemia leads to a negative calcium balance and subsequent bone demineralization through regulation of the calcium–parathyroid hormone (PTH) axis (Napoli et al, 2017 ). Furthermore, PTH is demonstrated to be negatively correlated with bone mineral density (BMD) and positively correlated with osteoporotic fracture in the patients with type 2 diabetes (Wang et al, 2018 ). Sustained exposure to high glucose may impair bone formation through reducing 1,25-dihydroxyvitamin D 3 [1,25(OH) 2 D 3 ] receptor numbers (Inaba et al, 1995 ).…”

Section: Introductionmentioning

confidence: 99%

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Aqueous Extract of Mori Folium Exerts Bone Protective Effect Through Regulation of Calcium and Redox Homeostasis via PTH/VDR/CaBP and AGEs/RAGE/Nox4/NF-κB Signaling in Diabetic Rats

et al. 2018

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Purpose: The present study is aimed to explore whether the aqueous extract of Mori Folium (MF) exhibits bone protective effect by regulating calcium and redox homeostasis in diabetic rats, and to identify the signaling pathways involved in this process.Methods: Diabetic rats were established using high-sugar and high-fat diet and streptozotocin (STZ) (30 mg/kg for 3 consecutive days). The serum levels of osteocalcin (OC), insulin-like growth factor-1 (IGF-1), tartrate-resistant acid phosphatase (TRAP), phosphorus (P), calcium (Ca), 1,25-dihydroxyvitamin D3 [1,25(OH)2D3], parathormone (PTH), advanced glycation end products (AGEs), superoxide dismutase (SOD), and malondialdehyde (MDA), total antioxidant capacity (TAC), 8-hydroxy-2′-deoxyguanosine (8-OH-dG), and interleukin 6 (IL-6) were determined by ELISA or biochemical assays. Histopathological alterations in the femurs were evaluated by the stainings of hematoxylin-eosin (H&E) and alizarin red S. In addition, femoral strength was detected by a three-point bending assay, bone microstructure was detected with micro-computer tomography. Bone material properties were examined by Fourier-transform infrared spectroscopy. Furthermore, the expressions of IGF-1, runt-related transcription factor 2 (Runx2), osteoprotegerin (OPG), receptor activator of nuclear factor kappa-B ligand (RANKL), cathepsin K, AGEs, receptor of advanced glycation end products (RAGE), NADPH oxidase 4 (Nox4), and nuclear factor kappa-B (NF-κB) in the femurs and tibias, and the alterations in the levels of calcium-binding protein-28k (CaBP-28k), transient receptor potential V6 (TRPV6), and vitamin D receptor (VDR) in the kidneys and duodenums were determined by western blot and immunohistochemical analysis.Results: Treatment of diabetic rats with MF aqueous extract induces an increase in the levels of OC and IGF-1 as well as a decrease in TRAP level in serum. MF treatment also upregulates the expression of OPG, downregulates the expressions of AGEs, RAGE, Nox4, NF-κB, and RANKL, which leads to improve bone microstructure and strength exhibited by an increase in cortical area ratio, cortical thickness, and trabecular area ratio as well as ultimate load, elastic modulus, and bending stress in the femurs and tibias of diabetic rats. In addition, MF aqueous extract preserves bone material properties by decreasing the ratio of fatty acid/collagen and increasing the ratio of mineral/matrix in the femurs of diabetic rats. Moreover, MF treatment increases the levels of P, Ca, and 1,25(OH)2D3, and decreases the level of PTH in the serum, as well as upregulates the expressions of TRPV6 and VDR in the duodenums and CaBP-28k in the kidneys of diabetic rats. Additionally, MF has ability of rebuilding redox homeostasis and eliminating inflammatory stress by increasing the levels of SOD and TAC as well as decreasing the levels of IL-6, AGEs, MDA, and 8-OH-dG.Conclusions: MF treatment may improve bone quality through maintenance of calcium homeostasis via regulating the PTH/VDR/CaBP signaling, and elimination of ox...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Aqueous Extract of Mori Folium Exerts Bone Protective Effect Through Regulation of Calcium and Redox Homeostasis via PTH/VDR/CaBP and AGEs/RAGE/Nox4/NF-κB Signaling in Diabetic Rats

et al. 2018

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“…[29][30][31][32] In middle-aged and elderly people, the level of estrogen is decreased, the intestinal absorption of calcium is decreased, 1, 25-(OH) 2 , and D 3 production in the kidney are decreased, and secondary hyperparathyroidism occurs and promotes bone resorption. 33 In patients with T2DM, adipose tissue, especially visceral fat, may have a negative impact on bone health by secreting adipokines and inflammatory factors that increase bone resorption. 19 The accumulation of bone-marrow fat may also increase the risk of fracture in these patients.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Value of the RA-Adjusted Fracture Risk Assessment Tool in the Fracture Risk Prediction of Patients with Type 2 Diabetes Mellitus in China

Hu¹,

Li²,

Zou³

et al. 2021

IJGM

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Objective This study aimed to explore the clinical value of the fracture risk assessment tool (FRAX) in the fracture risk prediction of Chinese patients after replacing rheumatoid arthritis (RA) with type 2 diabetes mellitus (T2DM) in the FRAX algorithm. Methods A total of 1,047 patients with T2DM from the Endocrinology Department of the Third Affiliated Hospital of Nanchang University were enrolled in this study. Dual-energy X-ray absorptiometry (DXA) was then used to detect their bone density. RA in the FRAX algorithm was replaced with T2DM, and the new RA-adjusted FRAX was used to assess the fracture risk of the patients. Results The sensitivity, specificity, and Youden’s index of the RA-adjusted FRAX to the treatment opinions on T2DM-associated hip fractures were 0.4761, 0.9642, and 0.4403, respectively, while the sensitivity, specificity, and Youden’s index of RA-adjusted FRAX to the treatment opinions on T2DM-associated major bone osteoporotic fractures were 0.0080, 1.0000, 0.0080, respectively. The DXA and RA-adjusted FRAX both showed acceptable consistency in the treatment recommendations for hip fractures in patients with T2DM (κ = 0.49) but had poor consistency in treatment recommendations for major bone osteoporotic fractures (κ = 0.010). The body mass index (BMI) scores, femoral neck-bone mineral densities, and number of males in the same treatment opinion group were significantly higher than in the different treatment opinions group ( P < 0.001). Conclusion RA-adjusted FRAX is a useful clinical tool for evaluation of hip fracture risk for Chinese patients with T2DM, and the accuracy of fracture risk prediction for male patients with T2DM and patients with T2DM with high BMI scores or high femoral neck-bone mineral density is higher.

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“…In addition to non‐enzymatic glycosylation of bone collagen, several other factors contribute to increased bone fragility in diabetes, including the diabetes course, insulin resistance, accumulation of fat in the bone marrow, and low bone turnover . Furthermore, for patients with diabetes, in addition to the fall‐related factors and variations in fasting plasma glucose, secondary hyperparathyroidism due to vitamin D deficiency is also an intrinsic risk factor for fractures.…”

Section: Fracture Risk and Bmd In T2d Patientsmentioning

confidence: 99%

Management of fracture risk in patients with diabetes—Chinese Expert Consensus

Liu

Zhu

et al. 2019

Journal of Diabetes

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The Associations Between Hypovitaminosis D, Higher Pth Levels With Bone Mineral Densities, And Risk Of The 10-Year Probability Of Major Osteoporotic Fractures In Chinese Patients With T2Dm

Cited by 12 publications

References 40 publications

Aqueous Extract of Mori Folium Exerts Bone Protective Effect Through Regulation of Calcium and Redox Homeostasis via PTH/VDR/CaBP and AGEs/RAGE/Nox4/NF-κB Signaling in Diabetic Rats

Aqueous Extract of Mori Folium Exerts Bone Protective Effect Through Regulation of Calcium and Redox Homeostasis via PTH/VDR/CaBP and AGEs/RAGE/Nox4/NF-κB Signaling in Diabetic Rats

The Clinical Value of the RA-Adjusted Fracture Risk Assessment Tool in the Fracture Risk Prediction of Patients with Type 2 Diabetes Mellitus in China

Management of fracture risk in patients with diabetes—Chinese Expert Consensus

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