Low Bone Turnover Markers in Young and Middle-Aged Male Patients with Type 2 Diabetes Mellitus.

Accumulating evidence has supported an increased risk of osteoporotic fracture in postmenopausal women and elderly men diagnosed with diabetes mellitus. However, it is not uncommon for young and middle-aged male patients diagnosed with type 2 diabetes mellitus (T2DM) to suffer from osteopenia or osteoporosis. Few studies focused on this population group are available. The aim of this study is to evaluate bone metabolic status and investigate the influence of T2DM on bone metabolism in 30-50-year-old men. Anthropometric assessment and blood samples were obtained from 160 patients with T2DM and 69 nondiabetic volunteers. Serum parathyroid hormone (PTH) and bone turnover markers (BTMs), including serum procollagen type I N-terminal peptide (PINP), osteocalcin (OC), and β-cross-linked C-telopeptide of type I collagen (β-CTX), were analysed. No significant differences were observed based on age, body mass index, systolic blood pressure, serum calcium, phosphorus, creatinine, total protein, and albumin levels when comparing T2DM and control groups. Fasting blood glucose, HbA1c, triglyceride (TG), total cholesterol, and low-density lipoprotein cholesterol were significantly increased, while high-density lipoprotein cholesterol was significantly decreased in the T2DM group. Compared with controls, diabetic patients showed lower serum PINP, OC, and PTH levels, whereas serum β-CTX levels were similar between the two groups. Moreover, HbA1c levels were positively correlated with PINP and inversely associated with PTH levels. TG levels were negatively correlated with OC or β-CTX levels. Furthermore, multiple linear regression revealed a positive correlation between HbA1c and PINP levels. These results also revealed a negative association between HbA1c and PTH, and between TG and OC levels, even after adjusting for expected confounder factors. Collectively, these findings indicated that young and middle-aged male patients with T2DM showed a lower turnover state resulting from bone formation inhibition. Glucose and lipid metabolic disorders may affect bone formation through different pathways.

Liu XX ，Jiang L ，Liu Q ，Zhang J ，Niu W ，Liu J ，Zhang Q ... -  《-》

Low serum levels of bone turnover markers are associated with the presence and severity of diabetic retinopathy in patients with type 2 diabetes mellitus.

Accumulating evidence demonstrates an association of type 2 diabetes mellitus (T2DM) and its microvascular complications with increased fracture risk. In this study, we aimed to evaluate the relationships between serum concentrations of bone turnover markers and the presence and/or severity of diabetic retinopathy (DR) among patients with T2DM. A total of 285 patients with T2DM comprising 168 patients without DR and 117 patients with DR were enrolled in the cross-sectional study. In the latter group, patients were further divided into patients of mild and severe DR stages. The biochemical parameters and bone turnover markers were determined in all participants. This study found that serum levels of procollagen type 1 N-terminal propeptide (P1NP), a bone formation marker, and the bone resorption marker serum β-cross-linked C-telopeptide of type I collagen (β-CTX) were more decreased in diabetic patients with DR than in those without DR, with differences remaining significant (P < .05) in multivariate linear regression models after adjustments for multiple confounding factors. Osteocalcin and β-CTX levels were further reduced along with the severity of DR among participants with DR. Moreover, multivariate logistic regression analysis revealed that lower serum levels of P1NP and β-CTX were associated with higher odds for the presence of DR, while β-CTX was associated with the severity of DR. Our results suggest that the development of DR might be involved in the progression of T2DM-induced deficits in bone formation and resorption or vice versa. Follow-up studies and further research are necessary to validate the associations and elucidate the underlying mechanisms.

An Y ，Liu S ，Wang W ，Dong H ，Zhao W ，Ke J ，Zhao D ... -  《-》

Association between serum ferritin and bone turnover marker levels in type 2 diabetes mellitus patients with non-alcoholic fatty liver disease.

Chen C ，Zhao Y ，Lv X ，Li K ，Wang Y ，Ma D ，Han M ，Zan X ，Guo X ，Liu J ... -  《-》

The levels of bone turnover markers 25(OH)D and PTH and their relationship with bone mineral density in postmenopausal women in a suburban district in China.

Gao C ，Qiao J ，Li SS ，Yu WJ ，He JW ，Fu WZ ，Zhang ZL ... -  《-》

Reference intervals of β-C-terminal telopeptide of type I collagen, procollagen type I N-terminal propeptide and osteocalcin for very elderly Chinese men.

The present study was intended to establish the reference intervals of β-C-terminal telopeptide of type I collagen, procollagen type I N-terminal propeptide and osteocalcin for very elderly (aged 80 years or more) Chinese men. A total of 1316 very elderly Chinese men were recruited into the study, and subjected to a survey of clinical characteristics, measurements of bone mineral density and assays of bone turnover markers. The relationships between underlying diseases and bone turnover markers were investigated, and the reference intervals of β-C-terminal telopeptide of type I collagen, procollagen type I N-terminal propeptide and osteocalcin for very elderly Chinese men were established through defining the central 95% range of all observations. We found that type 2 diabetes mellitus, chronic obstructive pulmonary disease and abnormal bone mass were associated with serum bone turnover markers (P < 0.01), and thereby identified 208 men without type 2 diabetes mellitus, chronic obstructive pulmonary disease and/or abnormal bone mass as healthy participants from 1316 very elderly Chinese men. The reference intervals for very elderly Chinese men were 0.13-0.63 ng/mL for β-C-terminal telopeptide of type I collagen, 18-94 ng/mL for procollagen type I N-terminal propeptide and 9-28 ng/mL for osteocalcin, respectively. The three turnover markers were moderately correlated to each other (P < 0.001), and all negatively associated with the bone mineral density of three sites (P < 0.05). We have established the reference intervals of β-C-terminal telopeptide of type I collagen, procollagen type I N-terminal propeptide and osteocalcin for very elderly Chinese men. Geriatr Gerontol Int 2017; 17: 773-778.

Shou Z ，Jin X ，Bian P ，Li X ，Chen J ... -  《-》